“Superbill” 101


A "super bill" is a specific type of receipt for services which includes diagnosis codes and treatment codes on it.  

We give out this receipt to clients who would like to get try to get reimbursement/credit from their health insurance company for Out-of-Network Services.

We've included an example of what our super bill looks like below. There is not standard form for these. Each practitioner/health care provider  may have a different form. Alternatively, some practitioners may provide you with a "HICFA" form instead of a super bill. It's an either/or kind of thing. Either/or should work for your insurance claim reimbursement needs. See our "HICFA Form" explained page if you want more info on that form for any reason. We issue super bills as opposed to HICFA forms because our super bill form is far less complex and easier to produce both digitally and manually. 

If we give you a super bill, you should:

  1. Contact your insurance company

  2. Get address for mailing in/faxing your super bill in -- Tell them you have a super bill for services provided out of network and ask them where to send that bill.  

  3. Ask if there is are any forms you need to fill out to accompany  your submission

  4. Ask if you needed to put a cover letter or other info with your bill.  They will need your subscriber ID somehow.  You might just be able to hand write that on the super bill, but we might suggest a short cover letter as outlined below.


RE: Super bill (Your name)—subscriber

To Whom It May Concern,

Please see super bill attached for acupuncture service. Please contact me if you have any questions.

High Regards,

Your Name,



Please call in advance to book if possible, but drop-ins are welcome!