What is an itemized bill?
An itemized bill (also known as a superbill) is a detailed document that includes information about the services you received, the costs, and the associated billing codes. Circle Medical can provide an itemized bill once you've completed your appointment and paid the invoice.
Important notes about itemized bills and reimbursement:
Itemized bills are typically used to file claims for out-of-network insurance benefits.
Receiving an itemized bill doesn’t guarantee reimbursement from your insurance. Your insurance determines coverage and reimbursement based on your plan.
You'll need to submit your itemized bill to your insurance within its timely filing window.
How to request an itemized bill:
1. Check your insurance benefits
Look for out-of-network benefits in your plan. Many PPO plans offer partial reimbursement for out-of-network care.
Check if there’s an out-of-network deductible. Most plans require you to pay a certain amount out-of-pocket before they start reimbursing.
Look at coinsurance rates. For example, if your plan covers 60% out-of-network, you’ll be reimbursed for 60% of the allowed amount, not necessarily what you paid.
Tip: If you are unsure, you can call your insurance and ask whether out-of-network telehealth appointments are eligible for reimbursement.
2. Complete your appointment and pay the invoice
Before an itemized bill can be issued, the following requirements must be met:
Completed appointment. You can only request an itemized bill after your appointment has taken place.
Appointment paid in full. All outstanding charges related to your appointment must be paid in full before Circle Medical can provide the itemized bill.
3. Request your itemized bill via chat
Once you've confirmed your out-of-network benefits with your insurance, start a chat in the app or web portal with our Care Team to request your itemized bill. Include the appointment date you need documentation for.
4. How to submit a claim with insurance
Go to your insurance’s website and find the out-of-network claim form.
Fill out the form with your details and attach your itemized bill.
Submit the claim through an online portal, mail, or fax, depending on your insurance's process.
If you aren’t sure where to send your claim, please call your insurance using the member services number on the back of your insurance card. They can guide you through the process.
5. What to expect
Processing can take 4-6 weeks.
Your insurance will send an Explanation of Benefits (EOB) detailing how much they covered.