Our Solutions - Institutional Medical Billing


Institutional billing is responsible for the billing of claims generated for work performed by hospitals, skilled nursing facilities, and other institutions for outpatient and inpatient services including the use of equipment and supplies, laboratory services, radiology services, and other charges. Institutional charges are billed on a UB-04. The UB-04 is the red-ink on white paper standard claim form used by institutional providers for claim billing.

The electronic version of the UB-04 is called the 837-I, the I standing for the institutional format.

Institutional billers sometimes have different tasks than professional billers. Institutional billers are mostly likely only responsible for billing or perform both billing and collections. Since hospital coding is a lot more complex than physician coding which is why the coding of institutional claims are performed only by coders.

Overall, regardless of whether it is professional or institutional billing, medical billers have an important job. In order to be successful all billers must be learn about 5 key areas:
  1. In order to submit medical claims efficiently, medical billers need to know or have access to lots of information for each insurance company.
  2. Medical billing staff has access to private, confidential patient health information and must be informed of ways to avoid violating HIPAA privacy and security rules.
  3. Familiarity with the type of billing software being used will save time, minimize errors, and prevent a lot of headache. Medical billers should take advantage of the training that software providers offer and if necessary, contact them as necessary when issues arise.
  4. Understanding coordination of benefit information means understanding how to bill claims in the correct order to prevent a delay in payment.
  5. Each part of a medical claim represents the information that is collected from the time the patient schedules an appointment until the patient receives services.




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