
Superbills
What is a Superbill? A superbill is a document, similar to an itemized receipt but with medical billing codes, that medical offices provide so that you, the patient, can submit a claim to be reimbursed by your insurance for services paid for out-of-pocket.
Blue Cross/Blue Shield
All claims must be submitted within 90 days of service. Most claims take about 14 days to process, though some may take longer. After 14 days, contact your insurance provider to inquire about the status of your claim.
Click here to view BC/BS Statement of Claim Form.
You will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed Subscriber Statement of Claim form
You must mail each form and receipt to:
Blue Shield of California Life and Health Insurance Company
P.O. Box 272610
Chico, CA 95927-2610
Anthem
Not all Anthem plans provide out-of-network benefits.
You may get reimbursement claim forms sent to you by calling customer service at 1-855-817-5786. You may also log into anthem.com/ca to find forms specific to your plan about out of network benefits.
You will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed Subscriber Statement of Claim form
There will be either a physical mailing address or email on the submission form to direct your claim to.
Humana
You may request reimbursement from Humana by mailing a copy of your insurance ID card & a completed Superbill form to the address on the back of your ID card.
You will need:
- A copy of your insurance ID card
- Transaction receipt (provided by us)
- Completed Superbill form (provided by us)
Aetna
Aetna provides multiple options to submit your claim. You may choose whichever you find most convenient.
You will need:
- Transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Your bank name, account number, routing number, contact number and other information when choosing reimbursement via EFT
- Aetna Medical Claim Form (click here)
Option 1: Submit your claim online
- Log into your online Aetna account
- Click on “Claims Center,” then “Submit Claims”
- Complete the online claim form
- Scan & upload all of your required supporting documents
- Click on “Submit Claim” to complete your claim
- Check your e-mail to ensure that your claim has been processed
Option 2: Submit your claim by fax, email, or traditional mail
- Click “Forms,” from the navigation menu
- Download the form you need
- Complete the PDF or Word document online OR download, print and complete the form by hand
- Attach all necessary supporting documents, including itemized bills and original receipts
Medicare
Medicare is generally excluded from reimbursement by superbill, however those that have made claims, say it may take up to 90 days for a possible reimbursement.
You will need:
- Completed CMS 1490-S form. Click here for CMS 1490-S form.
- Completed Superbill form (provided by us)
- Transaction receipt (provided by us)
You must mail your forms to the address on your Medicare card.
If you still need assistance with submitting your claim, please call 1-800-MEDICARE (1-800-633-4227).
Central Coast Alliance for Health
You will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed Member Reimbursement claim form (click here)
You must mail your claim and required forms to:
ATTN: CLAIMS
Central California Alliance for Health
PO Box 660015
Scotts Valley, CA 95067-0015
Cigna
There are instructions available on the back of Cigna’s medical claim form if you are unsure of how to proceed once it is filled out.
You will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed medical claim form (click here)
Claims must be submitted by mail to the address found on the back of your Cigna insurance ID card.
Kaiser
You will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed Member Reimbursement form (click here)
You must mail your completed forms to:
Claim Address
PO Box 12923
Oakland, CA 94604-2923
If you have any questions, you can call Member Services at 1-800-464-4000.
United Healthcare
Log into your online account to check if you are eligible to submit a claim online. For all other claims, you will need:
- Your transaction receipt (provided by us)
- Completed Superbill form (provided by us)
- Completed medical claim form (click here)
You must mail your required forms to the address listed on the back of your insurance ID card.