Submitting Your Receipt to Insurance 🧾

At Rupa Health, we send you an itemized receipt for your lab testing through email. However, to submit this to your insurance company for reimbursement, you'll need more information than what's on this receipt. These insurance receipts are often called SuperBills. 

We've created a Superbill template that you can fill out and submit to insurance for your lab testing. You can download the attached PDF, and fill it out using these instructions.

Filling Out the Template

1: Patient Info

Fill in the patient's name and date of birth.

2: Date of Service

This is the date that your Rupa Health order was paid on. This can be found on your invoice in the top right corner of your itemized receipt:

3: Practitioner Info

  • Name: the name of the practitioner that ordered lab testing for you.
  • Degree: the medical degree type that they have. For example: MD, DO, ND, NP, L.Ac, etc.
  • NPI #: this is their National Provider Identifier. You can find this in several ways:
    • You can use this NPI Lookup Tool
    • You can type into Google "Dr. John Smith NPI California"
    • You can ask your practitioner directly.
  • Address: this is your practitioner's address. This is often the practice address. If you're unsure, we recommend asking your doctor.

4: Diagnosis Codes

You'll need to ask your doctor for the diagnosis codes that correspond to the lab testing you completed. These are 3-digit codes, and there may be just one or multiple. They are often referred to as ICD-10 codes.

5: Item Descriptions

You'll need to fill out a separate item description for each lab test you completed.

  • Test Name: the name of the lab test you took, for example DUTCH Complete, GI-Effects, Gi-Map, etc.
  • Lab Company: this is the laboratory that shipped and processed your samples, for example: Genova Diagnostics, Vibrant America, etc.
  • CPT Codes: These are the billing codes associated with your lab test. You can generally find these on the lab company's website. Find their contact information here
  • Total paid: This is the amount you paid Rupa Health for the lab testing. It will be on the line item for your itemized receipt.

Don't forget to send in your itemized receipt along with this Superbill.


Download Fillable Template