The Key Differences between Inpatient and Outpatient Billing

When it comes to medical billing, there is a distinct difference between inpatient and outpatient billing. It is important for medical professionals to understand these differences and how they impact their billing procedures.

Inpatient Billing

Inpatient billing typically covers the expenses associated with a hospital stay including medication, laboratory, radiology services, room and board, nursing services, and other types of care. These expenses must be billed to the patient’s insurance provider in a timely manner in order to be reimbursed. In order to properly bill an inpatient stay, it is important to have the patient’s medical records, admitting diagnosis, and discharge condition.

Outpatient Billing

Outpatient billing covers outpatient procedures such as visiting a doctor’s office or clinic for an office visit, laboratory work or X-rays. It may also encompass more specialized care such as physical and occupational therapy, or skilled nursing care. Outpatient billing must be done quickly and accurately in order to receive payment. It is important to submit the correct information and procedure codes so that the patient’s insurance provider can properly review the claim and make a payment.

The Difference Between Inpatient and Outpatient Billing

The main difference between inpatient and outpatient billing lies in the amount of care that is required from medical providers. Inpatient billing involves billing for longer hospital stays while outpatient billing consists of shorter visits and procedures. Furthermore, inpatient billing requires additional paperwork and medical records in order to get reimbursed while outpatient billing is more focused on obtaining the correct procedure codes to receive payment.

In conclusion, understanding the differences between inpatient and outpatient billing is key in order for medical professionals to understand the specifics of medical billing procedures.