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Physician

Physician

We are here to serve our clients with professionalism and courtesy, while diligently processing their medical claims as efficiently as possible in order to collect all payments due from insurance companies and patients in an ethical, moral, and confidential manner.

Physician coding important?

There are still some cases that are charged on paper while Medicaid, Medicare, and most of the insurance companies accept electronic claims, as the necessary charging strategy. The 837-P is an electronic version of CMS-1500. The P stands for professional configuration. An expert physician billing services sometimes have numerous job responsibilities as compared to institutional or hospital billers.

Physician Billing

Physician billing is also called medical office billing or professional billing. The purpose of physician billing is to bill the claims to get reimbursement for the medical services provided by physicians to insured patients. It is also used to bill suppliers and non-institutional providers for their services.

The billing form used to bill claims is CMS-1500 or 837-P. There is no difference in these forms except that the CMS-1500 is the paper version whereas the 837-P is an electronic version of the same.

This type of billing is an important process to regulate various administrative tasks that are associated with medical practice such as scheduling appointments, greeting patients; check-in and registration, and collecting payment, etc. The services billed under physician billing include on both in-patient and out-patient services. However, the services falling under the domains of in-patient and out-patient services are billed only after insurance verification. It is because only selective in-patient and out-patient services may be billed for claims as per the insurance policy or insurance agreement of the patient.

It is important to note that physician billing may also include coding. This means in a few cases the medical biller is trained to perform both medical billing and coding. However, sometimes hospitals prefer to have both medical billers and coders who are trained to perform billing and coding respectively.

What is Physician Billing?

  • The purpose of physician billing which is also known as professional billing is to bill the claims to get paid for the medical services or procedures rendered by the physicians or healthcare providers to patients with healthcare insurance.
  • The physician billing form used for billing the claims is CMS-1500 or 837-P. Apart from billing form the CMS-1500 being a paper version and the 837-P an electronic version, there is no difference in these forms.
  • There are cases where Medicaid, Medicare, and other insurance companies accept only electronic claims as the necessary charging strategy. The 837-P claim form is an electronic version of CMS-1500 and “P” stands for professional configuration. An expert physician billing service at times can have multiple responsibilities compared to institutional or hospital billing.
  • Physician billing is a significant process that regulates numerous administrative tasks associated with medical practices like scheduling appointments, greeting patients, check-in and registration, and payment collections.
  • The services billed under physician billing include both in-patient and out-patient and fall under the domains of in-patient and out-patient services that can be billed only after patient verification.
  • Verification is essential because, very selective in-patient and out-patient services will be billed according to the insurance policies of the patient.
  • Please note that physician billing includes the complete medical billing process that involves medical coding too.
  • It means that medical billers have to be trained for both billing and coding processes. However healthcare professionals’ office and hospitals are employed with medical billing and coding teams to perform everyday billing activities.

Physician

No doubt about it; Ambulance Coding is a specialty unto itself.  It requires a totally unique set of codes that are not used for physicians’ or hospitals’ services.