Itemized receipt (superbill) for insurance reimbursement: how to ask for it

An itemized receipt, often called a superbill, is a document with the details of a visit you paid for yourself: who treated you, the date, the service you received and what you paid. A card receipt only shows that a payment happened; the itemized receipt explains what it was for.

People use it when they pay out of pocket and then ask their health plan, or the administrator of their health savings or flexible spending account, to review whether any of the cost can be reimbursed. It is a tool for you to file a claim. It is not a bill sent to your plan and it is not a promise that anyone will reimburse you.

You pay for the visit by credit or debit card on our secure payment page when you request it (plus Apple Pay, Google Pay or Link if they appear on that page). We do not bill insurance. There is no membership, and each visit's price is published on pricing.

Because you pay directly, we do not need plan approval and do not ask about copays or deductibles. The trade-off is that if you choose to file a claim, you file it. To understand what paying without a plan involved looks like, read seeing a doctor without insurance in Puerto Rico.

1. Before you book, ask your plan whether it reimburses telehealth visits that you paid for yourself and which documents it asks for. The answer depends on your plan and your coverage, and only they can give it. 2. Book and pay by card. Keep your card payment record. 3. Ask for the itemized receipt. Email [email protected] from the address you used to pay, tell us you need the itemized receipt and, if your plan asked for specific details, which ones, so we can tell you what we can include. 4. File it yourself. Send it to your plan or your HSA or FSA administrator the way they instruct, along with their claim form if they require one.

You can ask for the receipt whenever you need it, at the same email address, and keep a copy. Many plans set a deadline for filing claims, so ask how long you have.

Every plan has its own rules, but they commonly ask for some mix of these details: the patient's name, the date of service, the name and license of the clinician, a description of the service, the amount paid and proof of payment. Tell us what your plan needs and we will say what we can include.

Health savings accounts (HSA) and flexible spending accounts (FSA) follow federal rules plus those of each administrator. For general federal guidance, see the IRS publication on these accounts in the sources of this page. In practice, your administrator is the one who approves or denies the claim: ask whether a telehealth visit with a general practice physician counts as an eligible expense on your account.

If your plan or account asks for a code or another detail that is not on the receipt, tell us what you need and we will say whether we can include it. We cannot promise a specific format for every plan.

A receipt guarantees nothing. Your plan may reimburse part, all or none of the cost, depending on your coverage, whether the service is in or out of network, and whether you have an out-of-network benefit for telehealth. Some plans do not reimburse visits with clinicians outside their network.

So if reimbursement matters to you, call your plan first and ask in these words: "Do you reimburse a telehealth visit paid by the patient to a Puerto Rico-licensed physician, and which documents do you need?" Write down the name of the person you speak with and the date of the call.

If you want to see what a visit will cost before booking, read the good faith estimate. If you need to cancel or change a visit, the policy is on cancellations and refunds; that refund is for the visit itself and is separate from any reimbursement from your plan.

If your coverage is Medicare or a plan from the states, we do not bill either of them, and the rules for claiming out of network differ by plan. Read does Medicare and mainland insurance work in Puerto Rico? and confirm with your plan before you book.

You see Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician, in English or Spanish. The service is run by The Health Initiative, a nonprofit. We evaluate, diagnose and treat; if needed, we give you a lab order, and if appropriate, the doctor prescribes and we send your prescription to your pharmacy. We care for adults and children of all ages.

You must be in Puerto Rico during the visit. If the patient is under 21, a parent with patria potestad or a legal guardian stays on the video for the whole visit and shows photo ID.

Video visits every day, at any hour of the day or night, except on holidays when the clinic is closed. Every day, any time (Puerto Rico time). See how it works for the full process, from request to prescription. To book, go to the booking page.