Submitting a Super Bill

To submit a claim PhysMetrics, please download the “Reimbursement Request Form”

  1. Complete Form.
  2. Attach original itemized bills for chiropractic expenses. Bills should include:
    1. The name of the person for whom services were rendered
    2. Diagnosis
    3. Date and description of treatments
    4. The amount charged for each treatment
  3. Include receipts that indicate you have paid for chiropractic expenses and show the provider’s information, i.e. name and address. Generic receipts without provider information are not considered acceptable documentation.
  4. Claims may either be faxed or mailed via US mail (NO EMAIL). For questions, call (877) 519-8839 to speak to a representative.
Reimbursement Request Form