Get Superbill Template Dietitian

You can also make your own counseling superbill template. A complete superbill includes all of the following information: Identifying information about your client: This includes their name, date of birth, address, phone number, and any other information the insurer requires.

A superbill for insurance shows the provider's ID, the patient's diagnosis, and service(s) rendered. It also records their cost, the amount paid, and the patient's name and address. For another analogy, think of superbills as a vehicle. Superbills transport medical data from a doctor's office to an insurance company.

Components of a Superbill Provider's first and last name. Provider NPI number* Office location where the visit took place. Provider phone number. Provider email address. Provider signature. Referring provider name (if applicable) Referring provider NPI number (if applicable)

CPT® Codes 97802 and 97803 for Nutrition Services 97802 – For an initial assessment, face-to-face, 15 minutes per unit. 97803 – For a follow up visit or reassessment, face-to-face, 15 minutes per unit. 97804 – For a group visit (2 or more individuals), 30 minutes per unit.

To submit your super bill, contact your insurance company and ask for “member services” or check their website for instructions. There are usually 3 options for turning in a super bill: mail, fax, or through an online portal.

Filling Out a Superbill: Step-by-Step Instructions for Nutrition Professionals Client + Provider information. ... Tax ID number. ... NPI Number. ... Referring Provider Name and NPI. ... Diagnosis and CPT Codes. ... Payment details and date of service.

Essential client info like name, date of birth, address, and phone number. Superbills also list the practitioner's information, including the name of the practice, office location, and National Provider Identifier, or NPI number. An NPI number is a unique identification number for healthcare providers.