If you paid for an appointment yourself, you can ask Circle Medical for an itemized bill, also called a superbill. You send it to your insurance as an out-of-network claim. Circle Medical does not file that claim for you. Your plan decides whether to pay you back and how much.
Looking for something else?
Your appointment invoice or receipt: How to view and download your invoices
An HSA, FSA, or HRA card that will not save: How payments and billing work
What your plan paid for a visit billed to insurance: After your appointment: claims, EOBs, and charges
What to ask your plan before you book: Understanding your insurance benefits and what you might owe
What is an itemized bill?
An itemized bill lists the services you received, what they cost, diagnosis and CPT codes, and provider identifiers like the provider NPI and practice tax ID. It covers the appointment with your Circle Medical provider. Lab testing and prescriptions are billed separately by the lab and the pharmacy. See After your appointment: claims, EOBs, and charges.
It is not the invoice in Billing. The invoice is your bill from Circle Medical.
The itemized bill is the document your insurance, or your HSA, FSA, or HRA administrator, uses to process a claim. Many of them ask for both.
Will my insurance pay me back?
That depends on your plan's out-of-network benefits. Many PPO plans pay back part of the cost of out-of-network care. HMOs and many EPO plans do not pay for out-of-network care. Before you book, call the member services number on your card and ask:
Do out-of-network visits qualify for reimbursement? Ask about the type of visit you are booking, such as a video visit or an in-person visit.
Is there an out-of-network deductible, and how much of it is left? If you have not met it, your plan may pay nothing. The visit may only count toward that deductible.
What is the out-of-network coinsurance? If your plan covers 60%, it pays 60% of the amount it allows for the visit. That can be less than what you paid Circle Medical.
What is the deadline for filing a claim? Many plans require the claim within 90 days of the visit. This is often called a timely filing limit, and it varies by plan, so confirm the date with your insurance.
An itemized bill does not guarantee reimbursement. Your plan decides what it will pay. If it pays, it pays you directly, often by check. Circle Medical does not receive that payment.
This is separate from a claim Circle Medical sends to your plan. On those claims, the plan pays Circle Medical, and any remaining amount is charged to the card on file. See How payments and billing work.
Can Circle Medical bill my insurance instead?
If you booked the appointment as self-pay, we do not bill your insurance for it. Ask for an itemized bill the date of service, then submit the claim yourself.
I have Medicaid or Medi-Cal
Circle Medical is not contracted with Medicaid or Medi-Cal, including if you want to pay for the visit yourself. See How payments and billing work.
When can I ask for one?
Both of these have to be true:
The appointment has taken place.
The invoice for that appointment is paid in full.
You can ask after a self-pay appointment. You can also ask after an appointment we billed to insurance if you need the bill for your records, for an HSA, FSA, or HRA claim, or for a secondary insurance we could not bill.
How do I ask for it?
Start a chat with support.
Ask for an itemized bill and include the date of each appointment you need one for.
We usually send the bill within 3 to 5 business days. Some requests take longer.
How do I send it to my insurance?
Find the out-of-network claim form on your insurance website.
Fill in the form and attach the itemized bill.
Attach the invoice from Billing. That is your proof of payment to Circle Medical.
Submit it the way your plan asks: online, by mail, or by fax.
Send it before your plan's filing deadline. Many plans use 90 days from the visit. Yours may differ, so check with your insurance.
What happens after I send it?
Processing usually takes 4 to 6 weeks. Your plan sends an explanation of benefits showing how much it covered. It pays you directly, often by check.
What if my plan denies the claim?
Call the member services number on your card and ask why. Circle Medical cannot appeal a claim you submitted. If the plan says something else on the superbill needs to be corrected, start a chat and include the representative's name and the call reference number.
We cannot change the diagnosis codes or CPT codes on the superbill. A medical biller assigns those codes from your visit, and support cannot edit them.
Can I use it for an HSA, FSA, or HRA claim?
Yes. Ask for the bill the same way, then send it to your account administrator with the invoice from Billing if they ask for proof of payment. They decide whether to pay you back.
Related articles