What's the difference between an Institutional claim and a Professional claim?

Institutional billings use the 837i transaction. Professional billing typically uses the 837p transaction (or the CMS-1500 form in hard copy). We support both types of electronic claims and transactions in separate API products.

Institutional billing also sometimes encompasses collections, while Professional claims and billing typically doesn't. Professional billing controls the billing of claims generated for work performed by physicians, suppliers, and other non-institutional providers for both outpatient and inpatient services. People handling Professional claims typically understand both billing and insurance coding. Our APIs help support and automate insurance coding.