Hospital Billing Vs Professional Billing: What  Is Right For You?

Touseef Riaz

June 13, 2022

hospital based billing vs professional billing

The most common type of billing in the US is hospital billing or institutional billing. In institutional billing, clinics and hospitals charge fees for their services to patients and then bill insurance companies and patients. 

When physicians directly bill patients for their services, it’s called professional billing. It is not common, but doctors practice it to ensure they get paid for their work. In comparing hospital billing vs professional billing, there are some significant differences between them that you have to keep in mind. 

Professional billing is more expensive for patients than hospital billing. As physicians have to pay their administrative staff for their services, they receive these administrative costs from patients.

hospital billing vs professional billing

Professional Billing and Its Benefits 

When physicians or doctors bill you directly for their services, it’s known as professional billing. There are a few benefits linked with this billing like you can negotiate the price with the doctor directly, or if you have health insurance, the doctor can contact your insurance company to provide you the best possible treatment. 

Hospital Billing and Its Benefits 

When hospitals bill patients for their services, it’s known as hospital billing. The benefit of this billing service is that it’s easy for you to get paid your medical bills through your insurance. Firstly, you can’t negotiate the price with hospital staff, and you have to wait for a longer time to get your bill paid off through the hospital. 

Be its professional billing vs hospital billing now it depends on you, which type of billing service you want. 

Hospital Billing Vs Professional Billing: Key Differences

In hospital billing, patients are billed by hospitals. Doctors bill you directly for their services in professional billing. If hospitals bill you, they can adjust your bill if any error occurs. 

In professional billing, doctors may not be able to adjust changes inside the bill because they may have to receive approval from their organization. However, if the doctor is self-employed, they can adjust the bill. 

Errors in claims submission can occur in hospital and professional billing. One can commit a mistake in documenting accurate medical codes resulting in claim denials. It’s better to outsource your medical coding tasks to a reliable medical coding services company like Ucontrol Billing.  

Pros And Cons Of Hospital Based Billing Vs Professional Billing 

In discussing hospital billing vs professional billing, let’s explore their pros and cons. Each billing type has its positive and negative sides. 

In professional billing, the doctor is in charge of providing you with proper treatment and choosing tests to process. Doctors bill you directly for their services, and they may negotiate prices compared to hospitals. In professional billing, you have to pay bills before and wait for the insurance companies to reimburse you. 

While going for institutional billing, the hospital takes responsibility for your care. They recommend you different tests and procedures that can increase the cost of your medical expenses. There is a high probability of getting your insurance paid in hospital billing. 

In the end, it’s your choice to select from the above-mentioned billing types. Professional billing can be a more lucrative option if you have a good relationship with your doctors and trust them in their treatment. 

However, if you think the hospital provides more comfortable treatment and support, you can go for institutional or hospital billing. 

Do you have health insurance? If yes, then institutional billing can be an effective option for getting reimbursements. But if you are not having insurance, you can go for professional billing and can negotiate the price directly with the doctor. Even doctors will guide you about the best billing type suitable for you. 

How Can You Choose Doctors Billing Professionally?

Think of the doctor you want to consult and search. You might choose a doctor nearest to your home or the one covered by insurance companies, but you should consider multiple factors while selecting a physician who bills professionally. 

Look for qualified doctors who are experienced enough to provide you with their authentic services. Services and quality treatment can be impacted negatively by choosing wrong physicians. For example, a person might not have enough experience to treat your specific condition under professional billing. 

Check for their certifications and years of experience for your satisfaction. It’s a matter of life, and you can’t risk it by taking the medical services of any unqualified doctor. 

Few doctors bill directly to insurance companies in professional billing, while others may require you to pay bills and submit your insurance claims afterward. Ensure that doctor accepts your insurance plan. 

Outsource Medical Billing and Coding Services from Ucontrol Billing 

Uncontrol billing is a renowned US-based medical company providing trustable and cost-effective services to enhance revenue cycle management. whether it comes to hospital vs professional billing, we are capable of handling your billing and coding services effectively. 

We can handle both hospital billing and professional billings with complete efficacy to enhance your revenues and decrease your operating costs. If you are thinking of why you should take our services, you must look into these points: 

  • We are HIPAA compliant. 
  • Our quality services increase your revenues and decrease your operative costs. Overall profits escalate.
  • Minimizing your claim denial rates
  • Have the latest technology to perform every task with 100 percent accuracy. 
  • Our team members have years of experience in the medical billing industry and are competitive in every challenging environment. 
  • We have a successful track record of satisfying multiple clients. 
  • Our services’ prices are cost-effective and light on your pocket. We have never compromised in providing quality services. 
  • Your overall expenses reduce. 

“We only get paid when you get paid.” Your Revenue Cycle Management (RCM) will improve when we handle your medical billing and medical coding services.

As a healthcare provider, providing patient care is your utmost priority, so outsource your time-consuming and complex hospital billing and professional billing tasks from Ucontrol billing. 

Reaching to Conclusion 

Most of us have visited a hospital once, and the chances are high that you dealt with hospital billing. In this article, you learned the differences between hospital billing vs professional billing in detail. 

Both of them have significant differences in their approach. Still, the most widely used billing type in the US is hospital billing. 

If you want to outsource your medical billing and coding tasks and enhance your RCM process, consider Ucontrol billing. 

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