Physician Billing Services are also known as professional billing. Its main purpose is to bill the claims and to get paid for the medical services or even procedures that are rendered by the physicians or other healthcare providers to the patients including healthcare insurance. The basic usable form for billing the claims is CMS-1500 or 837-P in physician billing services.
Whereas, 837-P is an electronic version of physician billing while on the other hand, CMS-1500 is a paper version. As a necessary charging strategy, there are cases where Medicated, Medicare, and other insurance companies just accept only electronic claims. The “P” in the 837-P claim form stands for professional configuration. As compared to institutional or hospital billing an expert physician billing service may manage multiple responsibilities at times.
- Normally, physician billing is a significant process that maintains and regulates numerous administrative tasks like scheduling, greeting patients, appointments, and registration with payment collections.
- Remember, the physician billing services include a complete medical billing process including the medical coding too.
- Note that verification is an essential step. Must be very selective in-patient and out-patient services that must be billed according to the insurance policies of the patient.
- It is clear that the medical biller or medical billing service provider must have to be trained properly for both billing and coding processes as well. Hospitals and healthcare professional offices are employed with coding and medical billing teams who perform everyday billing activities.
Hospital Billing Services
Hospital billing is also mainly used to bill the claims for the in-patients and out-patient services. Healthcare organization or hospitals provide the billing services. Based on the same reason hospital billing is also termed as institutional billing.
Some medical facilities like laboratory services, medical equipment, and supplies also contain medical bill claims.
- UB-04 0r 837-I forms are used in the hospital billing for claims. The UB-04 is the paper version of billing while on the other hand, the 837-I form means the electronic version. Remember, “I” in 837-I form means “Institutional Configuration”.
- A simple difference between medical billing and hospital billing is that institutional medical billing deals with the medical billing processes and notes with the medical coding. While physician billing includes medical coding.
- The medical biller for the hospital performs the duties of billing and collections. However, as compared to physician billing hospital billing is much more complicated.
Boosting the Revenue with Physician Billing and Hospital Billing
Physician and hospital billing both stay dissimilar when it comes to revenue payments or increasing revenue reimbursements. As hospital and physician billing both play a huge role in preventing denials and fraudulent deeds.
- As the best option to avoid errors and payment loss issues most hospitals and healthcare providers choose outsourcing physician billing.
- As compared to physician billing, hospital billing is considered to be extremely complex. However, it is another reason why the institutional cases are carried out by the coding expert.
What are Physician Billing Services?
Following are the basic services those are provided by the physician billing:
- Patient Payments and posting of insurance
- Denial review and Management
- Statement process for patient and mailing
- Extensive Follow-Up Insurance
- Appeal of all Denied/low Paid claims
- Report Management