Physician and Hospital Billing-What’s the Difference?

Physician billing sometimes referred to in the form of Ambulatory Surgical Center (ASC) billing or professional billing, refers to the method of billing for services that were provided or carried out by health professionals or a physician which also covers inpatient and outpatient services.

Most of the time, these claims are invoiced electronically using form 837-P. Institutional billing is the process of submitting claims for work or procedures performed by institutions such as nursing facilities, outpatient and inpatient centers, and hospitals. In addition, these types of claims require the electronic version 837-I or the paper form UB-04. The hospital or institutional billing is generally more complicated and requires billers who are separate coders.

In the area of doctor billing goes, it is clear that the function of coders and billers is frequently merged. When we speak of medical billing and coding one must be aware that both physician billing services and hospitals billing companies have a similar skill set however, the distinction is between the coding companies and their names.

The difference between hospital billing and physician billing:

Physician Billing

Professional billing, also known as Physician billing is responsible for charging of cases for procedures performed by doctors or other suppliers and non-institutional providers for outpatient and inpatient administrations. On the CMS-1500 form, the professional fees were assessed. The form is in white and the letters are printed with red ink. In addition, the form CMS-1500 is can be used by both doctors and suppliers for charging cases.

There are still cases that are made with paper. Medicaid, Medicare, and the majority of insurance companies accept electronic claims as the appropriate charging method. This is an online copy of the CMS-1500. The P is a reference to professional configuration. Professional physicians billing services can have a variety of duties compared to institution and hospital billing.

Remember that professional billers may be required to be knowledgeable about billing and coding techniques. If you do some research and find out that a variety of medical billing training programs offer a combination of medical billing and code.

Hospital Billing

Hospital billing, also known as institutional charging is responsible for instances arising from work performed by hospitals, specialty nursing centers, and various organizations for outpatient and inpatient administration. Additionally, it involves the use of equipment, items, radiology services lab services, as well as other charges.

In UB-04, institutional fees were invoiced. The UB-04 is a common case form with red ink on the white paper used by institutions as suppliers to file cases. This is the 837-I, an electronic copy of the UB-04. Then I refer to the institutional configuration.

In some instances, hospitals billing services have a specific job when compared with professional billing professionals. The main functions of billers at institutions are the collection of funds, billing, and also the management of billing.

Since hospital coding is more complicated than ASC code, this could be one of the main reasons for the reason that coding for hospital cases is only carried out by coders. So, it is evident that the billing of hospitals and doctors requires skilled billers and coders to increase reimbursement and profits. Furthermore, it may have an impact on the management of revenue cycles.