Physician Bill vs Hospital Bill – What’s The Difference?

1
Physician Bill vs Hospital Bill Whats The
Difference?
2

• These terms might seem interchangeable at first
  glance, but they actually have fairly distinct
  processes thatll cause your practice a lot of
  unnecessary bother if you dont get it rightso,
  lets break down the disparities between the two
  in this article.
• Physician Billing
• When we talk about physician billing, were
  mainly referring to the billing process for all
  the medical services rendered by healthcare
  physician 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 youve provided
  into universal medical codes that insurance
  companies recognizenot only so youre reimbursed
  faster and without error but also so that you
  stay compliant with all the relevant healthcare
  regulations.

3
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.

4

• 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 its so multi-faceted).
• Why Understanding the Difference Matters
• It might sound like were 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.

5

• You dont need us to remind you that small
  medical practices like yourselves typically work
  on way tighter budgetsnot to mention fewer
  resourcesthan 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 dont have this same
  kind of luxury.
• As such, any inefficient billing practices that
  are naturally going to follow by confusing
  hospital billing and physician billingwhether
  its not knowing what codes you should be using
  or even the services/resources that are
  involvedare going to cause some problems for
  your practices bottom line.

6
Partnering with Professional Medical Billing and
Coding Services

• Now, as smaller medical practices, chances are
  your specialties dont 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 thisand the fact that you generally
  just might not have enough staff to handle
  itits 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 youve 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 its out of use).

7

• If its not entirely clear yet, the point is that
  these arent sustainable tools for small
  practices to rely onwhat you really need is a
  dedicated medical billing and coding partner
  whos 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 nichesfrom family medicine
  to something a bit more specialized like
  gastroenterologyso regardless of what task it
  is, you wont need to worry about claim denials
  or delays in general theyll always get it right
  the first time so youre reimbursed quickly.