What is Professional Medical Billing?
Professional billing is a process that allows healthcare professionals to file and track their claims for health services, treatment, or care provided on behalf of people with medical coverage. This ensures that healthcare professionals have an accurate record of their service charges, so they are paid adequately.
What is Institutional Medical Billing?
Medical billing is the process of charging claims for out-patient and in-patient services performed by hospitals or healthcare facilities. Professional billers are responsible for both billing and collections. Institutional billers are assigned responsibilities that are not the same as professional billers. The primary difference between institutional billing and professional billing is that hospital or institutional billing focuses only on medical billing procedures, while professional billers include the coding aspect.
Types of Medical Billing Claims for Institutional and Professional Billing
There are different types of healthcare claims. Now we discuss two types of medical billing claims one is for professional billing and the other one is for institutional billing.
1. CMS-1500 For Professional Billing
CMS-1500 form is used for professional billing. The 837-P, which is the electronic counterpart of the CMS 1500 form, is used in professional billing. The letter “P” refers to professional configuration.
2. UB-04 For Institutional Billing
The UB-04 form is used for institutional billing. The 837-I is used for electronic claims in institutional billing. The letter “I” represents the institutional configuration.