Can I get a superbill to submit to my insurance or healthshare?

Can I get a superbill to submit to my insurance or healthshare?

As we state on our website: 
"Flourish is primarily a private pay membership-based practice. Some healthshare ministries recognize us as fitting within their definition of a Direct Primary Care (DPC practice) and provide discounts to their members who pair their health share membership with a Flourish membership. We can provide a superbill for individual clinic visits that include appropriate billing codes for patients who want to submit claims to their healthshare or traditional insurance company for reimbursement. "

This does not mean that a superbill can be created to cover either a monthly or annual membership fee as there are no procedure or diagnosis codes that exist that represents the various benefits of Flourish membership. As a member, you get a certain number of hours in your "time bank" that can be used however you wish, whenever you wish, and usage of those hours tend to be irregular throughout the year. The monthly membership serves as a nice way to budget paying for that time over 12 months in the case where more hours are used early in the year compared to later in the year.  The only scenario where a regularly occurring bill, (monthly membership fee) would be recognized is if you have a healthshare that provides either reimbursement for member fees paid to a clinic like Flourish (Samaritan) or indirectly paying for some or all of a membership fee by offering a discounted monthly premium if you are member of Flourish (Zion Healthshare offers this).

Please keep in mind the following guidelines we must follow to provide superbills without committing insurance fraud:
  1. We cannot provide a superbill with a dollar amount more than what you have paid to Flourish.
  2. We cannot provide a superbill for services that do not have a corresponding billing code accepted by insurance companies. For example, part of your monthly membership covers the cost and time involved of running the online supplement store and the member side of the website with all the online education and there is no insurance code for "supplement store access" or for zoom member educational meetings, etc. 
Under these guidelines, therefore, Flourish provides the following: 
  1. For new members, we provide a superbill of your initial consult upon request as the superbill corresponds to a specific visit at a specific fee. 
  2. Following this initial superbill, Flourish will provide an annual summary superbill of your visits for the year.  Trying to provide interim superbills throughout the year is often impossible because the superbill amount might exceed what you have paid since payment is spread evenly over 12 months and usage is variable. 
  3. If you want an interim superbill at any time other than the end of the year summary, we can take the time to see if it is possible and draft a superbill, but please keep in mind that we might have to reflect a lower dollar amount on the superbill in order to avoid generating a superbill that exceeds what you have paid. This process can be time consuming (pulling payment information and adjusting superbill pricing on a line item basis to ensure everything ties out to make sure we are not committing insurance fraud), and therefore this time will be applied against your time bank. 
  4. Superbills generated by Flourish will include the following industry standard information.  Time spent responding to requests for additional information or requests for us to contact your insurance company or healthshare directly will be applied against your time bank. 
PROVIDER INFORMATION
  1. Provider first and last name
  2. Provider NPI number
  3. Office location where the visit took place
  4. Provider phone number
  5. Provider email address
  6. Provider signature

PATIENT INFORMATION
  1. Patient first and last name
  2. Patient phone number
  3. Patient date of birth (DOB)

VISIT INFORMATION
  1. Date of visit
  2. Procedure Codes and Description (CPT)
  3. Diagnosis Codes and Description (ICD-10)
  4. Modifiers if applicable
  5. Units or Minutes
  6. Fees Charged

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