Requirements for Itemized Bills and Superbills

An itemized bill, otherwise known as a superbill, is necessary to process any medical claim. It must include:

• Patient name
• Provider name
• Provider NPI
• Date(s) of service
• CPT code(s) and/or revenue code(s)
• Units for each code
• Charges for each code
• Diagnosis code(s) indicating the reason for the visit
• Amount Paid ($0 Balance)

Are you on a Sana First Health Plan (SFHP)?

If you're submitting a superbill for specialist or other care that required a Sana Care referral, a valid referral must have been on file for the care you received.

The referral must match the care being submitted for reimbursement. If the service required a referral and there was no valid Sana Care referral on file, the reimbursement claim will be denied.

Submitting a superbill does not replace the Sana First referral requirement.