The optometry Superbill form, also known as an optical claim form, is a standard form used to bill health insurance providers for services provided by an optometrist. The form is typically used to bill for services such as eye exams, contact lens fittings and prescriptions, and vision therapy. The optometry Superbill form can be used to bill both private health insurance providers and Medicare. Generally, the form must be completed by hand and submitted to the insurance provider either electronically or through the mail.
In the list, there is some good information regarding the optometry superbill. You'll have the likely time you may need to fill out the form and a few additional details.
| Question | Answer |
|---|---|
| Form Name | Optometry Superbill |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | optometry superbill pdf, optometry superbill, ophthalmology superbill template, icd 10 superbill optometry template |
PEN OPTOMETRIC OFFICE FORMS
Optometric Superbill
Reviewed and updated annually, the Superbill lists codes speciic to optom- etry. Available in both
Pricing: A Volume Savings
List Price |
PEN Price |
|
250 Forms |
$151.00 |
$127.50 |
500 Forms |
$168.00 |
$145.00 |
1000 Forms |
$242.00 |
$211.00 |
2000 Forms |
$385.00 |
$343.00 |
5000 Forms |
$748.00 |
$677.50 |
List Price |
PEN Price |
|
250 Forms |
$199.00 |
$167.50 |
500 Forms |
$220.50 |
$190.50 |
1000 Forms |
$317.50 |
$277.00 |
2000 Forms |
$506.00 |
$450.00 |
5000 Forms |
$982.00 |
$889.00 |
Click here for sample