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Superbills - Each Section & How to Customize It

Richard Abujasen
Updated


In OptiMantra, the patient’s receipt after a visit or purchase is called a Superbill. These Superbills should be created for each patient after every visit and/or after the EOB is processed in clinics that bill insurance.



IN THIS VIDEO AND ARTICLE YOU WILL LEARN


Superbills 1 - Each Section & How to Customize It | Loom - 16 April 2024 - Watch Video

*Please note, our team has streamlined the appearance of the superbill since the making of this video. 


The Importance of Superbills


Superbills are extremely important and summarize what happened in the visit or what products were purchased on a particular day. They document how the patient paid for those services or products. It's just as important to complete these Superbills when the charges were free / given at no charge or if the patient had already prepaid.


There are several reasons why you want to keep Superbills:

  • Patients may have a question about a payment, ask for a refund or contest a charge – and that can happen 6 months later or more, so having documented transactions is critical. 

  • Superbills also populate many of the reports in Analytics including your year-end accounting for taxes and your financial records.



Note we call all records of payment Superbills - but you can easily hide CPT and ICD codes if you just want to send a basic receipt!



What a Completed Superbill Looks Like


Let's take a look at what one of these Superbills looks like:

  • Here you can see the clinic’s logo, their address, patient address and phone number

and provider’s information.

  • Date of visit and diagnosis.

  • Services and products.

  • This particular patient paid a little bit by cash, check, and charge on this visit,, so this history is in one location. 
  • This Superbill can be used to turn into the patient’s insurance company for possible reimbursement, since it is their receipt. 
  • They can find all of their Superbills in the patient portal, if the clinic chooses to share  Superbills online.



Basics of a Superbill


The Superbill has three sections:

  1. What you did together

  2. What you’re charging the patient or client

  3. How the patient or client is paying you


Starting from the Patients tab, I can go into a patient's Action Menu > Superbill > pick a provider > Blank Superbill. This is the view the clinic will see when creating or editing superbills. Most sections are customizable. 


On the left is the Patient Summary:


  • It gives the patient name, DOB, age, gender, Patient ID, Patient Tags, and some insurance information, if you choose to collect insurance.

    • A summary of the patient balance as well as shortcuts to payment and superbill history are also shown here

      • This Bill - Denotes the amount due on the current superbill

      • Past Unpaid - Denotes the total balance due across all other superbills

    • If you have set up tag names under Settings > Communications > Patient Tags, then you can ADD and SAVE them at the top of the superbills or on the patient's profile.

  • The Visit Details shows Date of Visit, Location, and Provider on all Superbills, but you can decide whether or not to show the Diagnosis/ ICD10 code selectors.

    • Note: If you create the superbill from a Chart note that include ICD10 codes or CPT codes these will be copied into the superbill PDF even if they are set to not display.


Under Visit Details you will see the “Services” section - This is where you begin recording what you did together:


  • Services are separated into five main categories:

    • Office Visits

    • "Add Services" will pull from your offerings, which are set up in Settings> Services> Services (Fee Schedule)

    • "Add Package" will pull from your packaged services set up in Settings> Services> Service Packages - please do not try to discount the packages - since they should only be discounted when they are created under Settings 

    • Procedures

      • "Add Procedure" will pull from your Services (Fee Schedule) with those that have a "service type" of Procedure appearing at the top

    • Lab Tests

      • "Add Lab Test" will pull from your offerings in Services (Fee Schedule) with those that have a "service type" of Lab appearing at the top

    • Modifiers (Optional)

      • "Add Modifier" will allow you to add an existing modifier to the appointment

      • "Add Custom Modifier" will allow you to create your own 

    • Other Services

      • "Add Other Services" will pull from your offerings in Services (Fee Schedule) with those that have a "service type" of Other appearing at the top

      • "Add Class" will pull from your class offerings, which are set up in Settings> Services> Classes

      • "Add A Gift Card" will allow you to create a gift card for the patient or another recipient

      • Recipient name will be what populates onto the gift card "To:" 

  • Discounts can be added by a % or a flat $ amount on each line for anything in Services, Procedures, Lab Tests, Other Services or Products & Supplies. 
  • To remove a line item, please click on the garbage can.
  • If a patient has purchased a package previously, the "Subscribed Packages" button will be pink with a badge displaying the number of packages
    • Clicking this will allow you to access and use the existing package
  • You can decide to show or hide the Procedures, Lab Tests and Modifiers sections.
  • Other Services will be needed for clinics that offer classes or sell gift cards.




Next you will see the Products & Supplies Section, As Well As Copay, Deductible and Coinsurance.


  • Products & Supplies

    • The "Search Your Inventory" field will draw directly from your personal inventory and display amount on hand after adding a product to the superbill.

    • "Search OptiMantra Database" will display a library of different products, not directly tied to your inventory count

    • If you do not sell Products & Supplies in your clinic, you can hide this section. 

  • Copay, Deductible and Coinsurance

    • Only clinics submitting insurance claims would need the Copay, Deductible and Coinsurance. 

    • The note section  provides information involving online booking, recurring payments or custom notes. This section will populate on the Superbill, but  can also be added to the patient statements by clicking the Print These Notes On Account Statements button


The Summary of Charges – displays what you are charging the patient based on what you did together:


  • It will display the totals for each charge types above. 

  • If you would like to do a % discount for the entire charge type and not a single item, it will apply to all the items in a section above, by typing in any of the discount boxes

  • The Adjustment Debit and Credit section can also be used for unique situations and it’s best to set a tag to label the situation.

    • Examples of some adjustments that could be tracked in Analytics are donations, office supply use, or one-off specials like “50% off initial visits in the month of April.” 

  • If you are submitting Insurance claims, this section will be handy and we recommend you watch our insurance video where we’ll talk more about copay adjustments.

  • This is also the best place if you are porting over outstanding balances or credits from a previous EMR,  $50 credit… CREDIT tag

  • Let me show you where to create these adjustment categories in Settings > Payments > Customize Superbill > Adjustment Categories

  • Add Adjustment Category > choose the type – credit or debit > decide on the code name and a brief description before saving. Having the tags exactly set when you run your analytics reports will allow you to easily be able to filter on this particular topic.  Plus it will be easy for the accountant to understand what the adjustment was used for.




Back on the superbill - next in the summary is the Subtotal Charges 

  • Tips can be added by % or $ amount
  • Most clinics should not need the Insurance or Previous Balance boxes. 
  • Once everything is entered, the total will be here. 
  • There will an amount in red to alert you if the patient has an outstanding balance across other superbills
    • The two buttons below can direct you to their Check Balance or View Superbills pages.


In the last section you can record how your patient paid :

  • The payment can be entered by recording cash, check, or charge. 

    • (Cash) $ -

      • Cash transactions

      • The prepaid  section will populate when services are used from packages.

    • (Check) $ -

      • The Payment check line has a drop down menu and can be used to record any other payments made outside of Opti, like Zelle, Cherry, CareCredit or even a secondary credit card processor. 

        • By consistently noting the name of the other method, you will be able to easily match totals with your statements by filtering in Analytics.

    • (Card) $ -

      • We recommend saving the Payment (Card) line for credit card payments that are processed through OptiMantra.

      • We have reports that will help you cross reference the credit card superbills with the payments.

      • All card payments are processed as Credit (Debit is not available at this time)

      • If the card payment was run outside the superbill, cross reference the information to be populated by clicking "Card Payment History"


Take Card Payment will allow you to run a card (note this account is in Test Mode - to remove go to Settings > Payments > Processors)


  • If the patient does not have an existing card on file, you will need to enter the card number, expiration date, and 3 digit code.

  • Normally the Superbill amount will automatically populate. If not or if you want to pay a different amount, then manually change that number.

  • Click the box to Save card details for future use and select "Take Payment" to confirm the card was approved.

  • When the patient has paid in full the Balance will be $0.

  • Checking "Send Email"

    • If the balance is 0.00, it will dispatch a receipt to the patient.

    • If there is an outstanding balance, it will dispatch an invoice.

      • Invoicing can be configured in Settings> Payments> Patient Invoicing

  • The "Versions" button will give you a history of when edits were made to the superbill and a PDF snapshot of that save


The Additional Payment button is used to record more than one payment on the superbill. 


There are a number of scenarios where the balance shows a negative amount. (Refund / deposit / credit memo)


If a credit memo has been created then the superbill will highlight a pink "Apply Credit Memo" button showing that funds are available to use. 

  • Redeeming a gift card can be completed here or under Shortcuts > Administrative > Gift Cards.

Please double check your date, payment and balance are correct. Then you can send the superbill in an email as a receipt or use patient invoicing if they owe a balance by clicking this button or the clinic can print the PFD by clicking here.  ALWAYS click SAVE & CLOSE to preserve the information that was just created on the superbill.



If you would like to charge pre-payments, there are a few ways to set these up:

  1. Online booking - deposit fee or pay in full
    • Settings> Scheduling> Online Booking> Location Settings> Payment For Booking
  2.  Recurring subscriptions - CREDIT
  3. In office or over the phone pre-payment (manual)
    1. Create a new superbill
    2. Take a card payment which will generate a negative balance
    3. Select "Create Credit Memo" - this will take the "overpaid" / "prepaid" balance and generate a credit to the patient account
    4. When the patient returns for service, generate a new superbill for the visit as normal. When paying, the "Apply Credit Memo" button will appear pink. Click this to apply the credit from the prepayment to the new bill. 


Customize your Superbills


Finally to customize the different parts of your superbill,  please look at the Settings > Payments > Customize Superbill. To adjust any areas, change any “yes to no” or a “no to yes” and then SAVE


Note - you can always come back and update this down the road if you need to start adding adjustmetns, or want to start taking co-pays and insurance!




Want to learn the four ways to create a Superbill?  Click here




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