Superbill

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The Superbill is an intermediate stage that enables you to enter some information directly while you're waiting for more complete information. Such direct entries are therefore "pending" until more patient insurance information is added. Charges are automatically added to the Superbill when, for example, vaccines are administered and entered into a patient's chart, or when diagnostic tests are entered.

The Superbill eliminates duplication by enabling all of a patient's procedures and diagnosis codes for a particular visit to be entered just once. The Superbill is most often used by doctors, nurses, or physician assistants at the end of the visit. The office manager/billing department can review the Superbill to ensure that the proper codes were used before the final bill is generated.

Contents

[edit] Opening

If you have the patient's records open:

  • On the menu bar at the top of the screen, click Work Areas --> Superbill, or
  • Use the keyboard shortcut Ctrl + P.

If the patient's records have not been pulled up yet:

  1. Press F12 on your keyboard to open the Patient's Account.
  2. Click the Choose button and select the patient from the Patient Directory.
  3. Click the Superbill smart button at the bottom of the Office Practicum screen.

[edit] Creating your practice Superbill

Office Practicum has pre-loaded a complete list of CPT codes. In addition, there is a pre-defined Superbill with commonly used CPT Codes. Your practice may customize this Superbill to meet your practice's needs by adding or removing codes. To do so, follow these steps:

  1. Open the CPT code table by bringing your cursor to the menu bar at the top of the screen and clicking Utilities --> Maintain CPT Codes. The CPT-4: Physicians' Current Procedural Terminology window will open.
  2. Click the Complete List radio button and enter all or part of the code or description in the search field at the top of the window, then click the Search button. A list of matching codes will appear.
  3. To add a code to your Superbill:
    1. Click to highlight the desired CPT code in the table, then click the Edit button, located at the bottom of the window. The code information form will open in a new window.
    2. To enter a category, click on the Image:Down Arrow.jpg button beside the Category field and select a new category from the drop-down menu, OR type the new category name directly in the field.
    3. To enter a sort number, type a number in that field or use the up/down arrows (1-12 will appear in the left column, 13+ will appear in the right column).
    4. Click to check the Include in Frequently Used List check box.
    5. Enter the fees in the Fee Schedules fields.
    6. Click the Image:Check.jpg (checkmark) button in the tool bar to save.
  4. To remove a code from your Superbill:
    1. Click to highlight the desired CPT code in the table, then click the Edit button, located at the bottom of the window. The code information form will open in a new window.
    2. Change the sort number to "0".
    3. Remove the category by highlighting the category name with your cursor and pressing the backspace or Delete button.
    4. Click the Image:Check.jpg (checkmark) button in the toolbar to save your changes.
  5. Click the Exit button to return to the CPT-4 window.
  6. Click Done to close.

[edit] Entering a Superbill

  1. Follow the instructions above for opening a Superbill.
  2. A dialog box will appear, asking you to make a choice between using the highlighted (previously viewed) Superbill or a new claim. To use or modify an existing Superbill, click Use Highlighted Superbill. To create a new Superbill, click New Claim #. Either button will open the Pending Procedures form for the Superbill.
    NOTE: If a procedure was previously entered by the provider but not yet billed, another dialog box will appear asking you to confirm whether to use the ICD-9 code listed in the new Superbill entry. If you would like to bill for this procedure, click Yes. The ICD-9 code and accompanying information will be entered automatically into the Superbill, and displayed in the lower half of the Superbill form.
  3. Enter the following items in the lower left section of the form:
    1. Date - The date of the most recent claim will automatically appear. Change if you will be entering information for claims from a previous date.
    2. ICD-9 codes - Previously entered diagnosis codes will appear here. To enter different or additional codes, type them directly or click the DX button beside the desired field. Up to four diagnosis codes can be entered for each claim.
    3. Rendering Provider - For practices with multiple providers, click on the drop-down box to select the correct examiner.
      NOTE: If your practice has set up multiple locations and location groups, only staff members/providers that belong to the specified location can be designated as Rendering, Service or Supervising Providers.
  4. To select CPT codes, click on the correct category in the upper left section of the form, i.e., encounter, exam, hospital, newborn, procedure, or vaccine. As each category is highlighted, a list of frequently used CPT codes appears on the upper right-hand side of the screen.
    • As of OP 8.1 Build 164, you can click the newly added LookUp CPT button to search for the CPT code.
      Image:Superbill LookUp CPT.jpg
  5. Double-click on each applicable CPT code to enter it into the Superbill. The codes and associated claim numbers will appear in the lower half of the Superbill form.
  6. Click the Exit button. This will save the Superbill automatically.
  7. To confirm the creation of a Superbill, go to the Patient's Account. In the lower right corner of the Account form will appear the text, "Superbill Claim Started for", followed by the examiner initials.

[edit] Inputting a Superbill

When you input a Superbill, you are turning a pending Superbill into a claim.

After a Superbill is created and you attempt to enter charges for the patient, a dialog box will appear offering the choice of using the Pending Superbill Claim. To proceed with the procedure for turning the Superbill into a claim, refer to the procedure for Entering charges in the Charges page.

[edit] Editing a Superbill

[edit] Locating/working pending Superbills

Pending Superbills can be located/worked in one of the following ways:

  • From the Patient's Account:
    1. Press F12 on your keyboard to open the Patient's Account.
    2. Click the Choose button and select the patient from the Patient Directory.
    3. Click the Superbill smart button at the bottom of the Office Practicum screen.
    4. In the pop-up window, click on Use Highlighted.
    5. Once in the Add/Edit Charges window, click on Input Superbill to turn the pending Superbill into a claim.
  • From the Schedule:
    1. Press F7 to open the Schedule.
    2. Click to check the Bill Status boxes in the upper left-hand corner of the window.
    3. An appointment with a pending Superbill will be blue. Click on any of these appointments, then press F12 or click the F12 Account button to open the Patient's Account. *#Click the Choose button and select the patient from the Patient Directory.
    4. Click the Superbill smart button at the bottom of the Office Practicum screen.
    5. In the pop-up window, click on Use Highlighted.
    6. Once in the Add/Edit Charges window, click on Input Superbill to turn the pending Superbill into a claim.
  • From the Billing Center:
    1. Click on the Bctr button at the bottom of the OP screen open the Billing Center.
    2. Click on the Superbill tab. A list of all pending Superbills will appear.
    3. To view the Superbill, click on the [+] button to the left of the patient's name.
    4. Click on the patient's name, then click on the F12 Account button at the bottom of the screen to open the Patient's account.
    5. Click the Use Highlighted button in the pop-up window.
    6. Once in the Add/Edit Charges form, click on Input Superbill to turn the pending Superbill into a claim.

Note: This tab can be sorted by a single or multiple columns such as patient, date of service,etc. Click and drag the preferred sort column(s) to the area just above the column header. If it is already sorting by a non-preferred column, click and drag that column back onto the column header line.

  • From the Electronic Billing Center:
    1. Click on the Ebill button at the bottom of the OP screen to view a list of all pending Superbills.
    2. Click on the patient name, then click the Convert to Bill button in the upper right corner of the window.
    3. In the pop-up window, click on Use Highlighted.
    4. Once in the Add/Edit Charges window, click on Input Superbill to turn the pending Superbill into a claim.

Note: This tab can be sorted by a single or multiple columns such as patient, date of service,etc. Click and drag the preferred sort column(s) to the area just above the column header. If it is already sorting by a non-preferred column, click and drag that column back onto the column header line.

[edit] Splitting pending Superbills

You may need to split pending Superbills into multiple claims for one of several reasons:

  • If you have multiple Superbills for different dates of service
  • If you have a Superbill for one date of service requiring more than four ICD-9 codes for submission to a payer
  • If you have procedures performed on a given date of service, where one or more procedures is due by the patient and will not be submitted to the corresponding patient insurance

TO SPLIT A PENDING SUPERBILL (follow the directions listed below as per the applicable version of your program):

OP 8.1 Build 42 or higher:

  1. Press F12 on your keyboard to open the Patient's Account, then click the Choose button to select a patient from the Patient Directory.
  2. Click on Charges. All pending superbill items will be listed in the top portion of the screen.
  3. Click on the cpt lines you would like to split off to a distinct claim. To select multiple lines, hold down the control key while clicking on the lines.
  4. Once the items are selected, click on the Split button located toward the top of the screen. OP will now assign a distinct claim number to the selected items.
  5. Each Superbill should have a different claim number. Proceed to use highlighted Superbill and input the Superbills according to the standard procedure.

OP 8.1 Build 25 or below:

  1. Press F12 on your keyboard to open the Patient's Account, then click the Choose button to select a patient from the Patient Directory.
  2. Click on Superbill, located in the smart button bar at the bottom of the Office Practicum.
  3. Click on the Use Highlighted button.
  4. Click in the NP column to the left of each CPT code that you want to move to a separate claim.
  5. Click on New Page, located at the top of the Superbill form, to start a new claim for this patients. Items marked in the NP column will be moved to the new claim.
  6. A confirm dialogue box will appear; click Yes.
  7. Edit the ICD-9 codes and Rendering Provider, as appropriate, for the new claim.
  8. Click Exit to save.
  9. From the Patient's Account, click on Charges.
  10. A dialogue box will appear, listing both pending Superbills. Each Superbill should have a different claim number. Proceed to use highlighted Superbill and input the Superbills according to the standard procedure.

[edit] Printing a Superbill

  1. Press F12 on your keyboard to open the Patient's Account, then click the Choose button to select a patient from the Patient Directory.
  2. Click on the Superbill smart button, located at the bottom of the main Office Practicum screen.
  3. Click on the Use Highlighted button.
  4. Click on the Image:Printer icon.jpg button located toward the top of the screen.
  5. A standard Superbill will print to a Print Preview screen.
  6. Once the Superbill is printed, close the print screen to return to the Superbill screen.
  7. Click Exit to close.

[edit] Troubleshooting/FAQs

[edit] Templates

  • Creating a Superbill template
    • To create a superbill template to include more than one CPT code that are commonly billed at the same time:
      1. Click on the Superbill button located at the bottom of the main OP screen.
      2. Choose a patient (a test patient is recommended for template creation).
      3. Select the desired code(s); the selected codes will now appear in the lower portion of the grid.
      4. Checkmark the Templates box above the grid.
      5. Click on Add New button.
      6. Enter a name for the template in the box and click OK. The template name will now appear with the selected codes.

  • Editing an existing Superbill template
    • To edit an existing superbill template for the purpose of ADDING an additional cpt:
      1. Click on the Superbill button located at the bottom of the main OP screen.
      2. Choose a patient (a test patient is recommended for template editing).
      3. Checkmark the Templates box above the grid.
      4. Highlight the template you want to edit from the list of existing templates located in the upper left-hand corner of the screen, under Template name.
      5. Click on the Use button above the grid to populate the template you are attempting to edi.t
      6. Checkmark the Categories box above the grid.
      7. Select the desired code(s) to add to the existing set of codes in the template.
      8. Checkmark the Templates box above the grid.
      9. Highlight the template you are editing from the list of existing templates located in the upper left-hand corner of the screen, under Template name.
      10. Click on Modify Highlighted button. The template will now include the additional codes as selected.

  • Deleting an existing Superbill template
    • To delete an existing superbill template:
      1. Click on the Superbill button located at the bottom of the main OP screen and choose a patient (a test patient is recommended for template editing).
      2. Checkmark the Templates box above the grid.
      3. Highlight the template you want to delete from the list of existing templates located in the upper left-hand corner of the screen, under Template name.
      4. Click on the Delete button above the grid.
      5. OP will prompt as follows: "Delete this template?".
      6. Click on Yes.

[edit] How do I change the CPT code which is passed to the Superbill when an In House test is ordered?

The code needs to be changed in the HL7 Diagnostic Test Lookup Tables.

  1. Select Utilities > Manage Codes > Diagnostic Tests.
  2. Click on HL7 Diagnostic Test Utilities.
  3. Click on the tab labeled List of Tests Performed by Each Facility.
  4. Click on the Activate Button.
  5. Select In House Tests from the drop-down box.
  6. Expand the In House Tests by clicking on the Image:Add.jpg (plus sign) to the left of In House Tests.
  7. Select the desired test and click on the edit button to the left of the test name, button has three lines and three little boxes . You will now be on the Diagnostic Test Name Information box.
  8. Edit the CPT Code field to the correct code (you may type in the desired code or use the CPT code look up).
  9. Click on OK to exit.
    Note: The new code entered will now appear on the Superbill when the test is ordered under In House Tests.

[edit] Why can't I create a claim/input Superbill for one of my doctors/providers?

The doctor/provider must be associated with the patient's insurance record, if the doctor/provider is credentialed with the payer. If the doctor/provider is not credentialed with the payer, OP will prompt you to select a supervising (credentialed) provider for billing purposes.

  1. Click on Utilities > Manage Codes > Insurance Payers > Insurance Payer - Provider Info.
  2. On the screen that opens, locate the insurance payer in the table.
  3. Click on the plus (+) sign to the left of the payer name.
  4. If the doctor/provider is NOT associated with that particular payer, his/her name will NOT appear.
  5. Click on the Image:Add.jpg (plus) sign in the grid, below the MD field, to ADD this doctor/provider. The "Insurance Carrier Provider Info" screen will open.
    NOTE: You must only add the doctor/provider if he or she is associated with/credentialed by this payer.
  6. Complete the details on the Insurance Carrier Provider Information Screen as applicable
  7. Click Save.

You should now be able to create claims/input superbills for this doctor/provider under the insurance payer referenced above.

[edit] How do I delete "old" superbills?

You may need to delete pending superbills for claims that were billed manually or superbills that were generated on an alternate billing system.

  1. Click on the ebill button at the bottom of the OP screen. The Electronic Billing Center screen will open.
  2. You will see a list of patient names in a green-colored grid. Click on the Image:Add.jpg (plus) sign to the left of the patient name to view the contents of the pending superbill.
  3. For each superbill you want to delete, click on the name of the patient
  4. Click on the Edit button in the upper left-hand corner of the screen.
  5. When the popup box appears, click on the button Use Highlighted Superbill.
    NOTE: If a 'Confirm' popup box for diagnosis appears, click on yes - it does not matter what diagnosis is on the superbill since it is being deleted. If a second 'Confirm' popup box appears, click yes again.
  6. The Superbill - Pending Procedures screen will now open.
  7. Click on the Delete All To the left center of the screen.
  8. A popup box will appear to "Confirm" that you wish to delete all entries. Click Yes.
  9. Click on Exit to return to the Superbill tab of the e-bill screen. Select the next superbill to delete and repeat the steps above.

[edit] Why do I have 2 pending superbills for the same date of service and how do I merge them into one claim?

When adding diagnostic tests or vaccines to the superbill, it may create two entries.

  • You must choose the superbill entry with a claim # greater than 2. By choosing the entry with a true claim # and hitting the Use Highlighted Superbill, the other entry (listed with the claim # '2') will be merged with the superbill in the charges screen.
  • If neither of the 2 pending superbills has a claim # '2' (i.e both of the superbills have 6 digit claim numbers), then you should delete the superbill with the least amount of cpts and manually add these cpts to the alternate superbill.

[edit] If I create a Superbill will it pass the ICD-9 to an encounter note?

If you enter the code under the Procedure tab in the encounter note it will pass it to the Superbill, but the reverse is not true. The program cannot automatically assume that the Superbill you created applied to a specific note. You can enter the ICD-9 and CPT code under the Procedure tab even if the note is incomplete. While you will need to put the ICD-9 code in again, you should not put the CPT code in again, because this will enter two charges for the same visit.

[edit] How can I see/input the earliest pending Superbill if there are multiple Superbills pending for a specific patient?

To view/input the earliest pending Superbill in an account with multiple pending Superbills:

  1. Press F12 to open the Patient's Account form.
  2. Click the Charges button.
  3. In the pop-up window, select the Superbill you would like to input. If there are more than 2 Superbills pending for the patient, use the arrow keys on your keyboard (located to the left of the number key pad) to scroll down the list of pending Superbills.
  4. Once you can view the earliest date of service, click on this date and then click on Use Highlighted.
  5. Proceed to enter the Superbill according to standard procedure.

[edit] Why is an unknown provider's name appearing on the Superbill entries?

Occasionally, a window can get stuck with the wrong provider number attached or you simply need to modify the provider for the test entry. For example, a nurse may work with one provider on Monday, but on Tuesday they work with a different one. The nurse must change the Ordering Provider on the in house test window to reflect the proper physician linked with the order. It is very important to change the ordering provider before clicking on any of the tests.

  1. Press F8 to open the Patient Chart.
  2. Click Diagnostic Tests to open the Diagnostic Test Management window.
  3. Click InHouse Tests.
  4. In the Diagnostic Test Requisition form, click on the Image:Down Arrow.jpg (down arrow) next to Ordered by Provider, located in the upper left corner of the window.
  5. Select the correct provider's name from the drop-down list.
  6. Double-click to add the proper test(s) to the order.
  7. Make sure the superbill box is checked appropriately, either to pass or not pass the test to the superbill.
  8. Click OK to close.
  9. The workstation will now be set to show the correct provider's name, but you must remember to change it if you order for another provider in the practice.

[edit] How do I delete a superbill entry entered in error?

Line items on a superbill can be deleted through the Superbill screen or on the add/edit charges screen once the superbill is input.

  • Option #1
    1. From the Superbill screen, click on the cpt entered in error.
    2. Click on the Image:Delete.jpg (minus) sign located at the bottom of the screen.
  • Option #2
    1. Go to the Add/Edit Charges screen, once the superbill is input.
    2. Click on the cpt entered in error.
    3. Click on the Image:Delete.jpg (minus) sign located at the bottom of the screen.

[edit] Why are there immunizations in the Superbill when they are not on the chart?

If you add immunizations to the Patient Chart, they are added to the Superbill. If you then delete them from the chart, they do not get deleted from the Superbill. You have to manually delete them. You can verify they were initially added and then deleted by checking the Audit Trail for that patient.

[edit] See also

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