When we talk in normal terms, both hospital billing and physician billing fall under the category of medical billing. However, those who are not new to the field of medical billing understand that the smallest change can create a significant difference.
Professionals involved in medical billing differentiate between these two terms based on their purpose and the services involved in the billing process. In this blog we will understand the differences between hospital billing and physician billing.
So, Let's start!
Hospital Billing
Hospital billing is also known as institutional billing as it is used for in-patient services provided by a medical institution or hospital. Services and treatments performed by nurses also fall under the category of Hospital billing.
Apart from this, hospital billing is also used to bill claims for medical facilities such as laboratory services, medical equipment supplies, and radiology etc. These services are billed using the UB-04 form or the 837-I form. The UB-04 is the paper version whereas the 837-I form is the electronic version.
It is very important to note that hospital billing deals only with the billing process and not medical coding. Therefore, institutional billers are trained only in billing and collections.
Unlike physician billing, hospital billing is responsible for billing collections only. When compared to physician billing, hospital billing is more complicated.
Physician Billing
Physician Billing is also known as medical office billing or professional billing. The purpose of physician billing is to bill the claims and get reimbursed for the medical services provided by physicians to insured patients. It is used to bill suppliers and non-institutional providers for their services.
The billing form used to bill claim is CMS-1500 or 837-P. There is no significant difference in these forms except that the CMS-1500 is done on paper and 837-P is done electronically. The rest of the information is kept the same.
Physician billing holds great importance for regulating various administrative tasks that are associated with medical practice like scheduling appointments, greeting patients, Check-in, registration, and collecting payments. Services billed under physician billing include both in-patient and out-patient services.
However, the services that fall under the domains of in-patient and out-patient services are billed only after insurance verification. This is because only selective in-patient and out-patient services can be billed for claims as per the insurance policy or agreement signed by the patient.
Keep in mind that physician billing also contains coding which means the medical biller is trained to perform medical billing and coding. Healthcare organizations have both medical billers and coders who are trained to perform billing and coding respectively.
Boosting Revenue with Hospital & Physician Billing
Hospital Billing and physician billing are quite different from each other when it comes to ways of boosting revenue. Both these billing procedures have a pivotal role in preventing the revenue cycle from any sort of denials or frauds.
Professional medical billers like Unify Healthcare Services make sure that no claim or service goes unbilled. Outsourcing your medical billing to professionals like this is a great way of reducing stress from your shoulders. They ensure accurate billing and coding for your healthcare practice so you can focus on patient care with peace of mind.
