What are the differences between an Institutional claim and a Professional claim?

Professional billing typically uses the 837p transaction (or the CMS-1500 form in hard copy); Institutional billings use the 837i transaction. We support both types of electronic claims and transactions. Institutional billing also sometimes encompasses collections while Professional claims and billing typically don'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. One commonality: our APIs help support and automate insurance coding for both Institutional and Professional claims.


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