Gastroenterology Billing Services That Deliver Results
Efficient Gastroenterology Revenue Cycle Management Services for Better ROI
Boost Efficiency with Expert Gastroenterology Medical Billing Services
Gastroenterology practices diagnose and treat digestive disorders like acid reflux, Crohn’s disease, and liver conditions, using advanced procedures such as endoscopies and colonoscopies. However, gastroenterology billing is challenging due to complex coding, high-cost procedures, and strict insurance requirements, leading to potential claim denials and revenue loss. Efficient billing is essential for financial stability and smooth revenue cycle management.
RCM Workshop offers optimized gastroenterology medical billing services by ensuring accurate coding with up-to-date CPT and ICD-10 codes, streamlining claim submissions, and using RCM tools to track payments efficiently. We also carry out regular compliance audits and staff training and stay informed about payer policies to help reduce denials and maximize reimbursements. These methods enhance efficiency, minimize errors, and strengthen financial stability.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
1100
/Month
CHALLENGES
Challenges in Gastroenterology Billing
Improper Documentation: Proper documentation is key to sound gastroenterology coding and billing. Documents should contain explicit and accurate descriptions of encounters with patients, diagnoses, treatment plans, and procedures done. This can help with correct code selection and minimize claim denials.
Complex Coding Requirements: GI billing encompasses a few complex CPT codes. Some of them include esophagoscopy (43235), colonoscopy (45378), and endoscopic retrograde cholangiopancreatography (47420). Accurate code selection is a must to ensure proper compliance with billing regulations and correct reimbursement.
Lack of Training and Education: Sometimes, gastroenterology practitioners are not updated with the recent billing trends, submission protocols, and coding conventions for gastroenterology. This is a big challenge as the lack of knowledge and specialization makes it hard for them to manage claims efficiently, leading to rejections.
OUR PROCESS
Our Gastroenterology Billing Process Workflow
Our workflow for gastroenterology practice billing involves coordinated steps to ensure accurate and timely reimbursement. It starts with patient registration and insurance verification, followed by obtaining pre-authorizations for procedures like colonoscopies. After a patient visit, the provider documents the rendered diagnoses and procedures, which our coders convert into standardized codes (ICD-10, CPT, HCPCS). We enter these into the billing system to enter charges and submit the claim electronically to the insurer.
After that, we post payments based on the explanation of benefits (EOBs) received from payers. If any claims are denied or underpaid, our denial management team investigates the cause, corrects errors, and resubmits them. Then we bill patients for any remaining balances, and the practice may offer payment plans or financial counseling. Finally, we conduct regular reporting and compliance checks to monitor performance metrics and ensure adherence to regulatory standards.
Scheduling & Registration
Carry out well-coordinated appointment scheduling, update insurance details, and handle inbound and outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm primary and secondary insurance and benefits coverage of patients and verify their coverage, co-pays, co-insurance, and deductibles.
Prior Authorization
Initiate request for prior authorization with the payer, follow up to check its 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
Analyze 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
Our methodical approach to gastroenterology billing delivers valuable insights that help maximize your return on investment. We stay aligned with the latest industry regulations and standards, ensuring your facility remains audit-ready and protected from legal risks. With a commitment to excellence, our team consistently delivers superior financial outcomes.
WHY US?
Why partner with us
At RCM Workshop, we provide end-to-end revenue cycle management solutions tailored to gastroenterology practices — from verifying insurance to collecting payments. Our structured and efficient processes ensure precision and speed at every stage of the GI billing cycle. We spot patterns, anticipate claim denials, and identify areas for performance enhancement by leveraging data-driven analytics. By outsourcing gastroenterology billing services to us, you can offload administrative burdens and dedicate more time to delivering exceptional patient care.