Medical billing separates these two terms depending upon the services and motivation with the billing. Physician billing, also known as professional billing, performs both billing and coding, whereas hospital billing or institutional billing performs billing & collections and no coding.
Hospital billing is in charge of the billing of claims produced for work performed by skilled nursing facilities, hospitals, and several organizations for outpatient and inpatient administrations. It also includes equipment and supplies, radiology and laboratory services, and other additional charges.
On UB-04, hospital billings get billed. It is a standard case form with the red ink on white paper claim form used by institutional suppliers for guarantee billing. The electronic rendition of the UB-04 is called the 837-I, where the I represents the institutional format.
Also known as the Ambulatory Surgical Center (ASC) Billing, for the services performed by the physician for the inpatient and outpatient. All the tasks get offered at the same medical facility, like welcoming patients, scheduling appointments, registration and enlisting, administrative tasks, collecting cash, and other assignments such as medical billing.
Physician billing is responsible for the billing claims produced for work done by suppliers, physicians, and other non-institutional providers. Many times the role of billers and coders gets merged.
On a CMS-1500 form, physician billing gets charged. The CMS form is the red-ink-on-white-paper claim form used by suppliers and providers for case charging.
While some claims get charged on paper, Medicare, Medicaid, and most other insurers acknowledge electronic claims as to the primary billing method. The electronic version of CMS-1500 is known as the 837-P, where P represents the professional or physician format.
Irrespective of hospital and physician billing, medical billers are vital to submitting claims efficiently and boosting the revenue cycle management.
The medical billing staff have access to a bunch of data for each insurance company and have accessibility to patients’ confidential and private health information and therefore need to know how to follow HIPAA regulations for clean claims.
Experienced billers guarantee that no service goes unbilled, and understanding the coordination of benefits will help boost revenue and avoid making blunders while performing hospital and physician billing.