Understanding invoices and superbills

invoices and superbills are two different billing documents used for different purposes in eggmed understanding when each is created and how they are used helps ensure accurate billing, payments, and patient communication understanding invoices and superbills in eggmed eggmed supports two different billing documents invoices and superbills while they may look similar, they serve very different purposes and are used at different points in the billing workflow this article explains what each document is, what information it contains in eggmed, and when billing teams should use one versus the other what is an invoice in eggmed? an invoice is a request for payment it is used when the patient or another responsible party is expected to pay directly invoices are typically used for self pay clients copays, coinsurance, or patient responsibility balances situations where no insurance claim is being submitted in eggmed, invoices are tied to a billing account and track charges, payments, and outstanding balances what information an invoice includes in eggmed an invoice in eggmed shows invoice number and invoice date due date and payment terms total amount, amount paid, and outstanding balance invoice status (for example paid or unpaid) patient name and contact information billing account associated with the charges line items representing services or charges payment history and activity invoices can be downloaded as a pdf and sent to the patient directly from eggmed once payments are posted and the outstanding balance reaches zero, the invoice status updates to paid what is a superbill? a superbill is not a bill it is a clinical and billing summary that patients use to seek reimbursement from their insurance company on their own superbills are typically used when the provider is out of network the practice does not submit insurance claims on the patient’s behalf the patient needs documentation for reimbursement or flexible spending accounts eggmed generates superbills based on completed encounters and services what information a superbill includes in eggmed a superbill in eggmed includes a unique superbill id service date and place of service (for example, telehealth) total charge amount rendering provider billing provider patient details associated encounter reference delivery status (sent to patient and sent date) superbills can be downloaded as a pdf or sent directly to the patient by email they can also be voided if issued in error superbills do not track payments and do not update balances they exist purely for documentation key differences between invoices and superbills invoices are about collecting money superbills are about documenting services an invoice requests payment tracks balances and payments updates status as payments are posted is used for self pay and patient responsibility a superbill does not request payment does not track balances is sent to patients for insurance reimbursement is commonly used for out of network care in short if money is being collected in eggmed, you’re dealing with an invoice if documentation is being provided to the patient, you’re dealing with a superbill how invoices and superbills fit into the billing workflow a typical flow looks like this an appointment is completed services are recorded from the encounter depending on the billing setup an invoice is generated for patient payment, or a superbill is generated for patient reimbursement, or an insurance claim is submitted instead invoices and superbills may originate from the same encounter, but they serve different downstream workflows when billing teams should use each document use an invoice when collecting payment from the patient posting payments or reconciling balances tracking outstanding amounts use a superbill when the patient needs documentation for insurance reimbursement the practice does not submit claims on the patient’s behalf proof of services is required without collecting payment important things to keep in mind sending a superbill does not mark an invoice as paid voiding a superbill does not affect invoices or claims invoices and superbills are separate records, even if they originate from the same encounter billing teams should always confirm which workflow applies before issuing documents to patients