Professional vs. Institutional claims

Professional claims cover office and clinic visits, and are attributed to the rendering provider on the claim (or the billing provider if that's blank). Institutional claims cover hospital and ED encounters, and are attributed to the attending clinician instead.

Where this shows up:

Denial Intelligence, Reimbursement Intelligence and Encounter Coding Intelligence all work from professional claims only. If a lot of your billable work happens in a hospital setting, some of that activity won't be reflected in any of the three. All other features use a mix of institutional and professional.