SuperBill Review – Is It the Best Tool for Out-of-Network Claims Negotiation?

Fin-Tech /

  • Review all medical bills for errors
  • Complete and file the necessary reimbursement forms
  • Respond to and resolve any reimbursement claim denials
  • Maximize your reimbursement amounts

…all on your behalf, saving you time, money, and headaches.


Basically, SuperBill simplifies the out-of-network claims negotiation process by doing it all for you. All you need to do is upload your bills, and they’ll take it from there.


We know that there are lots of questions about how insurance works, to begin with, so let us answer some of those first.


What is out-of-network coverage?

When you visit a doctor or provider from your insurance plan’s approved list, you see an in-network provider. Out-of-network (OON) providers are any providers outside your plan’s approved list.


Health insurance plans develop contracts with medical providers to determine what rates they’re willing to accept as payment. Some plans only cover in-network services, and even if your plan covers out-of-network, it usually covers a lower percentage of the cost.


Always check with your insurance plan to determine the policy for out-of-network providers before scheduling your first OON appointment. You can expect to pay out-of-pocket, but your insurance plan determines how much you pay. Additionally, meeting your deductible can bring the cost of OON services down significantly.


If you want to see providers outside of your current network but your insurance will not cover OON services, you have a couple of options:


  • Consider switching to a new insurance plan: Start by comparing plans and rates just as you might compare online life insurance or home insurance plans, and ask your preferred OON providers what insurance plans they accept.
  • Negotiate directly with your preferred providers: Many will offer discounted rates if you agree to pay out of pocket rather than filing with insurance. That allows you to keep your current plan and still see the providers of your choice.


But if your insurance plan will process OON reimbursement claims, but the process is complicated, or you don’t believe you’re receiving the right reimbursement rates on your own, SuperBill is a possible solution – they can even help with bills for providers who refuse to accept insurance.


Out-of-network provider benefits: The inadequacy of in-network coverage

All that being said, have you noticed that the in-network providers through your insurance company aren’t always the best options for your healthcare? Insurance companies have been increasing the number of patients on their plans without increasing the number of providers at the same rate.

This can overload to in-network providers can mean:

  • Longer wait times for appointments
  • Overcrowded waiting rooms with excessive delays
  • Providers insisting on only handling one problem or condition per appointment
  • Short appointment times that make you feel rushed

What’s happening to our healthcare system? Many providers are opting out of contracts with big insurance companies, and other providers are increasingly being preferred by the insurance based on payment agreements, not the quality or specialty of care.

This can lead to lower-quality healthcare and fewer options for you and your family.


Sound depressing and all too familiar? There’s good news!


Out-of-network claims negotiation: What you’re missing

If your insurance plan does not offer a wide range of providers or services within its network, it may make sense to explore your out-of-network (OON) options.

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