SUPERBILL REQUEST

A Superbill is a document for patients to submit to their insurance for possible reimbursement for the services rendered. A superbill is essentially an itemized document that provides all the appropriate diagnostic codes, insurance bill codes, and lists all services provided to the patient. With this, the patient themselves can submit the superbill to their insurance for possible reimbursement of services.

Superbills can be submitted by patients to be used towards their deductible or to be used for their HSA/FSA account. This document is created by the clinicians which list everything an insurance company needs to determine if reimbursement is necessary.

We let you decide.

While the providers of Well Connected Chiropractic are concerned about helping you and others with aches and pains, we let you decide how you want to handle your insurance submission and if the great insurance you are paying for will provide you with reimbursement for taking care of yourself and your injuries.

SUPERBILL REQUEST FORM

Please fill out and submit the form below to request your Superbill.

GET IN TOUCH

Email:

info@wellconnectedchiro.com

Address:
26302 La Paz Road, Suite 214, Mission Viejo, CA 92691

Phone Number:

(949) 359-8385

BUSINESS HOURS

Monday | 9:00am – 5:30pm

Tuesday | 9:00am – 5:30pm

Wednesday | 7:30am – 11:30am

Thursday | 9:00am – 5:30pm

Friday | Closed

Sat & Sun | Closed