Physician billing is also known as professional billing or ACS billing. It is billing claims for healthcare services performed or offered by a physician or healthcare professionals. It includes both outpatient and inpatient services. Majorly, professionals bill these claims electronically with 837-P forms. In this blog, we will take a quick look at both physician and hospital billing.
Physician Billing
In physician or professional billing, experts perform billing against the procedures that physician and other suppliers perform for inpatient and outpatient administrations. The CMS-1500 form is used to charge professional charges. This is a white color form with red letters printed on it. Moreover, doctors and suppliers use this form for the purpose of case charging.
However, there are a few cases where this paper is used while Medicare, Medicaid, and many insurance companies take electronic claims. One e-version of the CMS-1500 form is known as the 837-P form. Here, P represents professional configuration. Sometimes, services of ACS have various job roles than the hospital or institutional billers.
You should know that a professional biller needs to know both coding and billing methods sometimes. For this, there are many training programs that offer combined coding and billing.
Hospital Billing
It is also known as institutional charging. It deals with the work performed by hospitals specialty nursing, and many other institutes for inpatient and outpatient administrations. Moreover, it also includes using the supplies and equipment, laboratory services, radiology services, and any charges. Hospital charges are billed on UB-04. This is a white color form with red-ink printing that institutional suppliers use to file cases. The UB-04’s e-version is 837-I. Here institutional configuration is represented by ‘I’.
Sometimes, institutional billing facilities need to perform special tasks than professional billers. A few main functions that institutional billers need to perform are charging and collection and controlling the billing. Institutional coding is a bit more complex than physician billing. Therefore, billers must be highly skilled and certified professionals.
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