Superbill Details

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.

QuestionAnswer
Form NameOptometry Superbill
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesoptometry superbill pdf, optometry superbill, ophthalmology superbill template, icd 10 superbill optometry template

Form Preview Example

PEN OPTOMETRIC OFFICE FORMS

Optometric Superbill

Reviewed and updated annually, the Superbill lists codes speciic to optom- etry. Available in both 1-part padded and 3-part NCR formats, includes person- alized imprinting and sequential numbering at no additional charge.

Pricing: A Volume Savings

1-Part Padded

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

3-Part NCR Forms

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

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .