Gastroenterology Billing

Say Goodbye to Denied Claims & Delayed Payments
- with Expert RCM Solutions

Gastroenterology Billing Tailored for Your Practice

Gastroenterology is a specialized branch of medicine that focuses on the digestive system and its anomalies. However, these practices face unique challenges in the revenue cycle due to the intricate nature of diagnostic and procedural coding along with payer-specific protocols and increasing scrutiny of claims. The process of medical billing and coding gastroenterology practices is complicated and necessitates expertise and knowledge to ensure maximum reimbursement.

At RCM Workshop, we optimize gastroenterology billing services by incorporating an end-to-end comprehensive, efficient process that implements advanced technology and specialized expertise. Our billing specialists manage claims of complex procedures encompassing endoscopy, colonoscopy, diagnostic testing, transjugular intrahepatic portosystemic shunt (TIPS), endoscopic retrograde cholangiopancreatography (ERCP) and so on. With years of experience in this field, our specialized billers and coders help practices mitigate revenue leakage and generate maximum reimbursement. We assign specific codes for claim submissions across a variety of gastroenterology procedures including endoscopy (EGD, ERCP, EUS), therapeutic procedures (polypectomy, EMR, ESD) etc., resulting in clean claim submissions at the first time.

Unbeatable Service, Quality & Price

ACCURACY
0 %
TURNAROUND TIME
< 0 Hours
COLLECTION
0 %
PRICE
Starting from $ 1100 /Month

Challenges

Challenges in Gastroenterology Billing

Complex coding and billing guidelines: Gastroenterology practices encompass complex procedures such as endoscopies, motility studies, liver biopsies, etc. Assigning right CPT, ICD and HCPCS Level II codes can be difficult due to the wide array of procedures which lead to improper coding and claim denials.
Stringent documentation requirement: Specialized procedures within this practice demand detailed documentation to support the medical necessity of the services rendered. Proper documentation also requires compliance, which adds further complexity to the documentation process. Lack of accuracy in documentation leads to claim denials.

Challenges involving technological integration: Obsolete or incompatible technology can impede efficiency, resulting in errors in billing, coding and patient records. The integration of Electronic Health Records (EHR) also creates problems in efficient billing process. If there is any gap or discrepancy between the EHR and billing system, it can lead to rejected claims.

OUR PROCESS

Our Gastroenterology Billing Process Workflow

Gastroenterology billing services encompass a multitude of procedure specific codes that necessitate a billing solution tailored as per the need and requirement of your practice. We work with certified billers and coders who ensure each claim has been submitted in a timely manner and with appropriate codes. At RCM Workshop, we provide tailored solutions that understand the subtleties of each code to ensure maximum reimbursement while staying compliant with the regulatory guidelines along with ICD-10 and CPT codes.

Our team uses a meticulous approach and industry best standards to streamline the billing process and enhance cash flow. Our end-to-end claims management process is engineered to accelerate the reimbursement timelines. Starting from claim submission to denials, we integrate cutting edge technologies and data-driven insights to identify and resolve potential issues before they arise. We ensure to enhance first-pass acceptance rate, safeguarding your revenue streams. Our standard operating procedure includes meticulous review to ensure each claim is compliant before submission.

Scheduling & Registration

Carry out well-coordinated appointment scheduling, updated insurance details, and handle inbound and outbound calls from/to patients.

Eligibility & Benefits Verification

Confirm patients’ primary and secondary insurance and verify their benefits coverage, co-pays, co-insurance, and deductibles.

Prior Authorization

Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.

Medical Coding

Check the accuracy of codes and modifiers according to specialty and assign corresponding and appropriate charges to the codes.

Charge Posting

Enter the charges for the services provided into the billing system including the cost of the medication and the administration fee.

Claims Edits & Submission

Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.

Payment Posting

Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.

Denial Management

Analyse and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.

AR Management

Follow-up with payers to gather status for unpaid claims, and their resolution.

Patient Collection

Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.

BENEFITS

Outcomes guaranteed

By choosing RCM Workshop as your trusted gastroenterology billing partner, your practice gains access to a dedicated team of experts and a proven workflow that guarantees financial outcome. Our strategic approach ensures your practice receives faster reimbursements with minimized denials.

Efficient insurance verification

>99% clean claim submission

Efficient authorization management

<24 hours turn-around time

Efficient Charge Entry

Efficient processing for flawless financial records.

Efficient denial management

<5% claims denials

Proactive accounts receivable follow-up

<40 days AR & reduced aging

Better coordination & process optimization

improved patient satisfaction

WHY US?

Why partner with us

At RCM Workshop, we provide comprehensive revenue cycle management services that covers every aspect of your gastroenterology billing needs, starting from insurance verification to payment collection. Our structured and methodical approach to gastroenterology billing ensures accuracy, efficiency and speed at every step of your revenue cycle. We employ data-driven insights to identify trends, predict denials, and highlight opportunities for performance improvement. Partner with us to relieve yourself from the administrative responsibilities so that you can focus more on delivering excellent patient care.

Guaranteed Improvement in Reimbursement and
Cash Flow

Reduction in Denials
and AR

Transparent reporting
– NO BLACK BOX

100% data security
& HIPAA compliance

On demand scale up
of operation

Significant Reduction
in Cost > 75% Savings

Simple & No
Cost transition

Flexible & Unbeatable
Pricing Plan