What are the two most common types of medical billing?

Asked by: Douglas Shanahan  |  Last update: May 24, 2025
Score: 4.6/5 (40 votes)

In addition, the way a facility handles medical records and billing can also differ. For people interested in becoming a medical biller, it's crucial to recognize that different types of medical billing exist. Healthcare providers may follow two types of medical billing: institutional and professional.

What are the two types of medical billing?

The processing of medical claims across varying facility types and specialties is significantly different. No matter what, medical billers work with one of two types of billing: institutional billing or professional billing. We're going to look more closely at the differences between facility vs professional claims.

What are the two types of billing?

Types of Billing
  • One-Time Payment. A one-time payment is a lump sum amount paid in full at the beginning of a transaction – this method is often called “pay-as-you-go” or transactional billing. ...
  • Recurring Payment. ...
  • Subscription Billing. ...
  • Usage-Based Billing. ...
  • Tiered Billing. ...
  • Payment Plans. ...
  • Accuracy. ...
  • Data Security.

What are the two types of forms used for health services billing?

The CMS 1500 form and the UB-04 form are two different types of medical claim forms used for submitting claims to insurance companies. While they serve similar purposes, they are designed for different types of healthcare providers and services.

What are the two major types of medical reimbursement in the United States?

Healthcare Reimbursement Methods
  • Fee-for-service: This model is a direct reimbursement of medical providers for the services they provide. ...
  • Value-based: This model reimburses a provider based on the quality (not quantity) of their performance and is a favored model for the future of healthcare delivery.

Medical Billing and Coding (Everything You Need To Know About This Industry)

43 related questions found

What are the 2 types of healthcare?

Health care can generally be divided in two major categories mainly traditional (integrative/complementary/indigenous/alternative) and modern (western/conventional/allopathic/orthodox).

What are the two types of medical claims forms?

Common Types of Medical Claim Forms (CMS 1500, UB-04, ADA Dental) Medical claim forms come in various types, each serving specific purposes in the healthcare billing process. The most common types include the CMS 1500 form, the UB-04 form, and the ADA Dental form.

What are the two formats used for medical billing?

Healthcare providers may follow two types of medical billing: institutional and professional. How these two medical billing systems process claims can vary vastly. This guide explores these two medical billing systems in more depth, including HIPAA in medical billing.

What are the two types of forms used for health services billing quizlet?

Two medical office forms are used to complete the CMS-1500 claim form : The patient information form, which is filled out or updated by the patient & the patient encounter form. Since HIPPA, the payment portion of TPO : Gives providers the authority to release claim-pertinent PHI to obtain third-party payment.

What two claim forms are the most common in healthcare?

The two most common claim forms are the CMS-1500 and the UB-04. These two forms look and operate similarly, but they are not interchangeable. The UB-04 is based on the CMS-1500, but is actually a variation on it—it's also known as the CMS-1450 form.

What are the two main types of bills?

Public bills pertain to matters that affect the general public or classes of citizens, while private bills pertain to individual matters that affect individuals and organizations, such as claims against the Government.

What is the most common method of billing clients?

Hourly billing is the most common billing practice across many industries. Hourly billing involves a dynamic generation of billing records based on time and expenses logged to projects with an hourly contract.

What are the two types of billing cycles?

Monthly Billing Cycles: The most common type, where merchants receive a single bill for all transactions processed during the month. This offers simplicity in tracking expenses. Quarterly and Annual Billing Cycles: Suitable for businesses with lower transaction volumes.

What are the two types of billing methods?

There are three types of billing methods: time-based, usage-based, and feature-based. Time-based billing is the most common type, where the customer is billed based on the duration of the service. Usage-based billing charges the customer based on the amount of resources or bandwidth they use.

What are the categories of medical billing?

Here's a quick look at the sections of Category I CPT codes, as arranged by their numerical range.
  • Evaluation and Management: 99201 – 99499.
  • Anesthesia: 00100 – 01999; 99100 – 99140.
  • Surgery: 10021 – 69990.
  • Radiology: 70010 – 79999.
  • Pathology and Laboratory: 80047 – 89398.
  • Medicine: 90281 – 99199; 99500 – 99607.

What is the hardest part of medical billing and coding?

Let's discuss a few hardest parts that appear in medical coding and can be perplexing for medical coders.
  • Keeping up on changes. ...
  • How to keep Up With trends in the medical billing and coding industry? ...
  • Bad documentation/missing documentation. ...
  • Dealing with complex medical cases. ...
  • Different requirements for different payers.

What are the two types of billing performed by insurance billing specialists?

If you're looking at how to start a medical billing and coding career path, you should know the two types of medical billing, which are professional billing and institutional billing.

What forms are used for medical billing?

The UB-04 form and the 837-I

The UB-04 form, also called the CMS-1450 is the paper version of the form, which is used in manual claims submissions. The 837-I is the electronic version, used by medical billers in institutions that file claims electronically.

What are the two types of EHR systems commonly used in healthcare?

The various kinds of EHR systems can be streamlined into two basic types:
  • A server-based EHR system, also known as a physician-hosted system.
  • A cloud-based EHR system.

What are the two types of medical bills?

Types of Charges
  • Inpatient Hospital Bill. Patients admitted to the hospital (inpatients) will receive separate invoices for some services. ...
  • Outpatient Bill. ...
  • Home Care Bill. ...
  • Billing for Other Professional Services at Our Hospitals.

What are the two most common methods of medical billing?

Professional vs.

Institutional Billing – Used by healthcare facilities like hospitals, nursing homes, and outpatient facilities. Institutional billing is more complex and typically involves the UB-04 form to bill for services rendered by multiple healthcare professionals and for facility-related charges.

What are Category 2 codes in medical billing?

Category II Current Procedural Terminology (CPT®) codes are developed to simplify reporting of performance measures and eliminate the need for chart abstraction. These supplemental tracking codes are used by physicians and hospitals to report specific services that contribute to positive outcomes and high-quality care.

What are the two 2 types of claims?

Three types of claims are as follows: fact, value, and policy. Claims of fact attempt to establish that something is or is not the case. Claims of value attempt to establish the overall worth, merit, or importance of something. Claims of policy attempt to establish, reinforce, or change a course of action.

What are the two types of filing systems typically used for paper medical records?

The two most commonly used filing systems to arrange paper-based medical records are chronologic and alphabetic. The chronologic system organizes records based on the date of service, with the most recent records filed at the front. This method allows for easy tracking of a patient's medical history over time.

What are the types of medical claims?

Types of Health Insurance Claims
  • Inpatient Claim.
  • Emergency Claim.
  • Planned Surgery.
  • Outpatient Claim.
  • Cashless Claims (Direct Billing Claims)
  • Reimbursement Claims.
  • About Us.