Do you want to help your clients with insurance reimbursement?  Do you want a coded receipt that you can just fill in the blanks with your client information in session and hand it to them?  Do you use paper charts and not want to mess with technology?  Then this coded receipt/ superbill is for you!

This coded receipt is a customizable print ready template.  All you need to do is plug in your business information, update icd10 codes to better match your business (if needed) and then print.

This version of a coded receipt is intended to be completed by hand in session.  That means, once you add your information, just print as many as you need!  After you write in the client information, check a box, add the units, rate, payment method and your signature then you’re ready to go.  Not sure what some of those things are- there are directions to help you as well!

This coded receipt is the easiest way to get started with providing a coded receipt right away. Note* this coded receipt does not create a statement and is not intended to be used for multiple appointments. Please see our other listing of coded receipts template for that option.

This customizable coded receipt/ superbill template is available for your usage in a word document (docx) form.  It includes:

  • 1 ready to print customizable coded receipt
  • Step by step directions for how to complete the coded receipt and what each item of content means.
  • A list of frequently used icd10 codes a link to access additional codes to save you time

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