What is the difference between 837I and 837P in EPIC Resolute?

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Multiple Choice

What is the difference between 837I and 837P in EPIC Resolute?

Understanding how 837 claim formats are used helps explain the difference. There are two standard 837 formats: institutional and professional. The institutional claim is used for facility charges—things that the hospital or facility bills for itself, such as room and board, facility services, equipment use, and other overhead items. The professional claim is used for services billed by clinicians—physicians or clinics—for their direct professional charges like office visits, consultations, and procedures performed by a provider. In EPIC Resolute, the system looks at the service type on the encounter and uses it to decide which 837 format to generate for submission. If the encounter involves facility or institutional charges, Resolute generates an 837I. If it involves professional services by physicians or clinics, Resolute generates an 837P. This separation ensures the data structures and required fields align with payer expectations. So the difference isn’t about outpatient versus inpatient, nor about clinics versus hospitals being identical. It’s about who is billing and what type of charges are being reported, with Resolute selecting the appropriate 837 format accordingly.

Understanding how 837 claim formats are used helps explain the difference. There are two standard 837 formats: institutional and professional. The institutional claim is used for facility charges—things that the hospital or facility bills for itself, such as room and board, facility services, equipment use, and other overhead items. The professional claim is used for services billed by clinicians—physicians or clinics—for their direct professional charges like office visits, consultations, and procedures performed by a provider.

In EPIC Resolute, the system looks at the service type on the encounter and uses it to decide which 837 format to generate for submission. If the encounter involves facility or institutional charges, Resolute generates an 837I. If it involves professional services by physicians or clinics, Resolute generates an 837P. This separation ensures the data structures and required fields align with payer expectations.

So the difference isn’t about outpatient versus inpatient, nor about clinics versus hospitals being identical. It’s about who is billing and what type of charges are being reported, with Resolute selecting the appropriate 837 format accordingly.

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