Physician Bill vs Hospital Bill – What’s The Difference
                     Physician Bill vs 
Hospital Bill – 
What’s The 
Difference?
• These terms might seem interchangeable at first glance, but 
they actually have fairly distinct processes that’ll cause your 
practice a lot of unnecessary bother if you don’t get it right—so, 
let’s break down the disparities between the two in this article.
Physician Billing
• When we talk about physician billing, we’re mainly referring to 
the billing process for all the medical services rendered by 
healthcare physician providers like yourself, so this tends to 
cover a pretty broad spectrum that ranges from simple things 
like routine check-ups to more intricate surgical procedures.
• In essence, this means translating the diagnosis, procedures, and 
even treatments you’ve provided into universal medical codes 
that insurance companies recognize—not only so you’re 
reimbursed faster and without error but also so that you stay 
compliant with all the relevant healthcare regulations.
Hospital Billing
• On the other hand, institutional (or hospital billing) revolves 
around the charges your patients will incur during their stay 
or visit to your medical facility, and this covers services that 
go way beyond just the professional expertise of your 
physicians, including, but not limited to, the following:
• Room accommodation
• Medical equipment usage
• Laboratory services
• Medications
• Other kinds of ancillary services your practice provides
• So, unlike physician billing, which primarily deals with 
professional billing, hospital billing involves both 
professional billing and institutional billing.
• For clarity, though, try to think of professional billing 
as handling services rendered by your healthcare 
professionals and hospital billing more for facility-
related charges (which ultimately makes hospital 
billing inherently a bit more complex since it’s so 
multi-faceted).
Why Understanding the Difference Matters
• It might sound like we’re making too much of a big 
deal regarding the importance of separating these 
two terms, but generally speaking, knowing the 
difference between these is probably one of the 
easier ways you stay financially stable as a small 
practice, given the implications of mixing them up.
• You don’t need us to remind you that small medical 
practices like yourselves typically work on way tighter 
budgets—not to mention fewer resources—than 
your larger counterparts and why they might be able 
to sometimes get away with delayed payments (or 
even compliance issues) sometimes because their 
revenue cycle management is already flourishing; 
you don’t have this same kind of luxury.
• As such, any inefficient billing practices that are 
naturally going to follow by confusing hospital billing 
and physician billing—whether it’s not knowing what 
codes you should be using or even the 
services/resources that are involved—are going to 
cause some problems for your practice’s bottom line.
Partnering with Professional 
Medical Billing and Coding Services
• Now, as smaller medical practices, chances are 
your specialties don’t exactly lie in handling all these 
particular nuances between the two kinds of billing 
practices, so this is naturally going to make you a lot more 
prone to errors.
• Because of this—and the fact that you generally just might 
not have enough staff to handle it—it’s not uncommon for 
practices like yours to utilize EHR software and other sorts 
of billing software to handle it for them, but this kind of 
thing can be notoriously expensive and time-consuming 
since you’ve now got to teach all your staff how to use it 
(never mind running into issues with maintenance that can 
halt your practices activities when it’s out of use).
• If it’s not entirely clear yet, the point is that these aren’t 
sustainable tools for small practices to rely on—what you 
really need is a dedicated medical billing and coding 
partner who’s actually got experience working directly 
with small practices (and all the specific challenges they 
face) rather than large ones, such as PMN.
• The medical billers and coders over at PMN bring over 20+ 
years of expertise to your practice and handle hospital and 
physician billing services in a range of different niches—
from family medicine to something a bit more specialized 
like gastroenterology—so regardless of what task it is, you 
won’t need to worry about claim denials or delays in 
general; they’ll always get it right the first time so you’re 
reimbursed quickly.