Superbill: How Out-of-Network Services Can Be Billed to Insurance in Zionsville

There are two types of providers when it comes to insurance billing in Zionsville: In-network and Out-of-Network.

In-Network Providers in Zionsville

In-network providers contract with individual insurance companies and bill the insurance company directly for reimbursement. They have pre-negotiated rates, services, and frequency of care that can be offered to patients that are determined by the insurance company, not the provider.

These limitations can often affect the care that you are receiving. This is something that the clinicians at Foundations Chiropractic choose not to participate with. We believe that services rendered should not be determined by insurance coverage, but instead should be determined by what the patient truly needs to get well.

Out-of-Network Providers

Out-of-network providers do not bill insurance companies directly. Instead, the patient can submit a superbill for reimbursement consideration to the insurance company and the insurance company will pay you directly for what is reimbursable.

This allows the patient to receive the care that is necessary without sacrificing certain aspects of care for insurance contracts. When it comes to the health of you and your family, we believe you deserve the right type of care to reach your health goals whether or not the insurance company covers it under contract.

However, we understand that you pay a premium for your insurance coverage every month and want to use your benefits! Submitting out-of-network claims allows you to use your insurance benefits without compromising the quality of our care

Good news is - being out of network allows us to offer administrative savings that makes our pricing affordable and often similar to what you would expect from a co-pay with an in network clinic. We also happily accept HSA cards 🙂

"So how will I be able to submit out-of-network claims and get reimbursed?"

The answer is with a Superbill!

A Superbill is a document for patients to submit to their insurance for possible reimbursement for the services rendered. A superbill is an itemized document that provides all the appropriate diagnostic codes (ICD-10 Codes), insurance billing codes (CPT Codes), and lists all services provided to the patient. This coded document allows insurance companies to see what services were rendered and what you paid for the services so they can determine possible reimbursement that they will then send directly to you. Superbills can be submitted to be used towards your deductible or to be used for your HSA/FSA account.

The Superbill will include:

• Patient’s name and information
• Practice name and information
• Provider Tax ID Number
• Provider credentials
• CPT codes for services rendered
• ICD-10 diagnostic codes
• Dates of services rendered

A superbill is not a receipt or an invoice. It is an itemized bill in which the services have already been paid for prior to submission to your insurance. If covered, you will be reimbursed a certain amount depending on your individual coverage.

The superbill only takes minutes to create and can easily be provided to you after your appointment so you leave with everything you need to submit - easy as that!

We recommend calling your insurance provider ahead of time in order to ask a few questions to get better clarification about your out-of-network benefits because everyone has different types of insurance plans and coverages.

Questions to ask your insurance

1. How much is my out of network deductible?
2. How much of my out of network deductible has been met this year?
3. What is my out-of-network deductible for chiropractic care?
4. What are my out-of-network benefits for chiropractic care?
5. How do I submit claim forms for reimbursement?

By asking these questions you will have a better understanding of what type of out-of-network coverage you have so there will not be any unexpected surprises.

We let you decide

The providers of Foundations Chiropractic are concerned about helping you get the care you need. We let you decide how you want to handle your insurance submission and give you the tools to determine if the insurance you are paying for will provide you with reimbursement. We provide you with the information you need to make the right choice to take care of the health of you and your family.