These terms might seem interchangeable at first glance, but they actually have fairly distinct processes that’ll cause your practice a lot of unnecessary bother if you don’t get it right – so, let’s break down the disparities between the two in this article.

Physician Billing

When we talk about physician billing, we’re mainly referring to the billing process for all the medical services rendered by healthcare providers like yourself, so this tends to cover a pretty broad spectrum that ranges from simple things like routine check-ups to more intricate surgical procedures.

In essence, this means translating the diagnosis, procedures, and even treatments you’ve provided into universal medical codes that insurance companies recognize – not only so you’re reimbursed faster and without error but also so that you stay compliant with all the relevant healthcare regulations.

Hospital Billing

On the other hand, institutional (or hospital billing) revolves around the charges your patients will incur during their stay or visit to your medical facility, and this covers services that go way beyond just the professional expertise of your physicians – including, but not limited to, the following:

– Room accommodation

– Medical equipment usage

– Laboratory services

– Medications

– Other kinds of ancillary services your practice provides

So, Unlike physician billing, which primarily deals with professional billing, hospital billing involves both professional billing and institutional billing.

For clarity, though, try to think of professional billing as handling services rendered by your healthcare professionals and hospital billing more for facility-related charges (which ultimately makes hospital billing inherently a bit more complex since it’s so multi-faceted).

Why Understanding the Difference Matters

It might sound like we’re making too much of a big deal regarding the importance of separating these two terms, but generally speaking, knowing the difference between these is probably one of the easier ways you stay financially stable as a small practice, given the implications of mixing them up.

You don’t need us to remind you that small medical practices like yourselves typically work on way tighter budgets – not to mention fewer resources – than your larger counterparts and why they might be able to sometimes get away with delayed payments (or even compliance issues) sometimes because their revenue cycle management is already flourishing, you don’t have this same kind of luxury.

As such, any inefficient billing practices that are naturally going to follow by confusing hospital billing and physician billing – whether it’s not knowing what codes you should be using or even the services/resources that are involved – are going to cause some problems for your practice’s bottom line.

Partnering with Professional Medical Billing and Coding Services

Now, as smaller medical practices, chances are your specialties don’t exactly lie in handling all these particular nuances between the two kinds of billing practices, so this is naturally going to make you a lot more prone to errors.

Because of this – and the fact that you generally just might not have enough staff to handle it – it’s not uncommon for practices like yours to utilize EHR software and other sorts of billing software to handle it for them, but this kind of thing can be notoriously expensive and time-consuming since you’ve now got to teach all your staff how to use it (never mind running into issues with maintenance that can halt your practices activities when it’s out of use).

If it’s not entirely clear yet, the point is that these aren’t sustainable tools for small practices to rely on – what you really need is a dedicated medical billing and coding partner who’s actually got experience working directly with small practices (and all the specific challenges they face) rather than large ones, such as PMN.

The medical billers and coders over at PMN bring over 20+ years of expertise to your practice and handle hospital and physician billing services in a range of different niches – from family medicine to something a bit more specialized like gastroenterology – so regardless of what task it is, you won’t need to worry about claim denials nor delays in general; they’ll always get it right first time so you’re reimbursed quickly.

If this is something you want to learn more about, we recommend getting in touch and making a simple phone with one of their helpful staff members over at (949) 215-5055. Still, it’s generally a bit daunting to make such a major switch if you’re used to handling your medical billing or coding in-house, so we’d suggest booking a face-to-face appointment at their office in Laguna Hills, Orange County, California, if you’d like some extra clarity.

FAQ

Are There Any Differences In Billing Processes For Services Provided In Different Medical Facilities?

Absolutely, so this can definitely be something that’ll cost you money if you don’t understand the difference beforehand. For instance, you’ll generally find that outpatient services in clinics, in particular, have completely different billing codes/procedures to the ones you’d see provided in hospitals or an ambulatory surgical center, so it’s paramount that you know the difference.

How Long Does The Medical Billing Process Take?

The duration of the medical billing process varies depending on factors such as the complexity of services rendered, insurance company processing times, and any billing-related discrepancies that need to be addressed. Generally, it can take anywhere from a few days to several weeks to receive payment for a claim, which is why it’s so important to get it right the first time.