Medical procedures are already complex, but the medical billing process that follows is no walk in the park either. As Dorsey College reports, there are actually two types of solutions for medical billing: professional billing and institutional billing. Read on to learn more about the two types of medical billing and determine which is best for your needs.
Institutional billing is a type of medical billing that’s used to process claims for in-patient and out-patient services provided by hospitals. This type of medical billing is also called hospital billing. Institutional billing covers a wide range of hospital expenses, including services provided by nurses, laboratory testing, imaging, and more. The biggest difference between institutional billing and professional billing is the fact that institutional billing is used for hospital services. Institutional billing also typically uses the medical billing method instead of the medical coding method, which is another key difference between the two. Institutional billing uses the UB-04 form, with the 837-I used for electronic institutional billing claims.
Professional billing is used for medical services provided by physicians or other healthcare professionals. More specifically, this type of billing is used to bill a patient’s insurance company for the services they receive. Medical coding is used for professional billing because these claims must be sent to insurance companies, so everything has to be accounted for. The medical coding process that comes with professional billing also dictates many of the daily practices of healthcare facilities, including scheduling appointments and processing payments. For professional billing, a CMS-1500 form is used. There’s also an electronic version of this form, which is called the 837-P.
Choosing the Right Solution
When it comes to professional billing vs. institutional billing, both solutions for medical billing are effective in different ways. There are pros and cons to each type of medical billing, and it’s important to consider the type of facility and various other factors when deciding which type to use.
Medical billing and medical coding can be complex, but there are solutions for medical billing that make things a little easier. If you want to save time and money with the medical billing and coding process, outsourcing can be a smart idea. Contact Sentinel Billing Solutions to learn more about outsourcing your medical billing and coding today.