Gastroenterology Billing: Best Practices to Maximize Revenue

Gastroenterology is the division of medicine regulating the digestive system and its dysfunctions. This specialization focuses on diseases affecting the gastrointestinal tract, including the organs from mouth into anus, along the alimentary canal. Physicians exercising in this field are called gastroenterologists. 

Gastroenterologists need to stay modernized on the several coding guidelines and payer-specific rules to maintain a compliant and financially flourishing practice. Billing and coding for gastroenterology remain challenging and require expert knowledge to ensure maximum compensation.

Additionally, gastroenterology billing requires the ability to track underpayments efficiently. This specification often surpasses the competency of most billing software and in-house billing staff. GI practices not adequately targeting underpayments face significant revenue issues.

Moreover, with the subsequent payment cuts affecting gastroenterology practice revenue, more practices rely on gastroenterology medical billing and coding companies to maximize their reimbursement.

  • Medicare has cut compensation for colonoscopy up to 17 percent, which has affected access to care. Colonoscopy is a life-saving procedure that significantly benefits colon cancer inhibition.
  • Incomplete colonoscopies are compensated at one-half the cost of a finished procedure with the corresponding code.
  • Though made no modifications in the Physician Quality Reporting and Value-based Payment Modifiers, there will be improvements to pay for quality reporting and other factors under the Merit-Based Incentive Payment System and Alternative Payment Models, claimed by the Medicare Access and CHIP Reauthorization Act.

The rules and regulations of insurance firms concerning insurance authorization have also become more established. Many insurance companies now have radiology interest’s managers and drugstore benefits managers. Physicians need to review and get appointments for CT Scans, MRIs, or complex radiology tests and make prescriptions.

All these changes can severely jeopardize the profits of gastroenterology practices and affect Medicare receivers, and authorities are calling for federal action to remedy the situation.

Benefits of Outsourcing it to 24/7 Medical Billing Services:

Outsourcing medical billing refers to hiring an external agency by a healthcare provider who takes care of all the medical billing aspects. At 24/7 Medical Billing Services, bring excellence, knowledge, and accuracy to billing and coding services while developing a revenue cycle without defects for your practice. With abilities across the revenue cycle chain- patient demographics entry, insurance verification, insurance authorizations, coding, billing, reconciling accounts, and denial management, we can add value to your organization through analytics-driven and result-oriented processing. 

Our team strives to advance a smooth billing, codingclaim submission, and payment posting process. We guarantee consistent accounts receivable follow-up and prior authorization to avoid claim rejections. Our denial management team’s #1 preference is driving your focus from denial management to denial prevention. Medical billing helps gastroenterologists offer high-quality care for their patients, concentrating on improving their administrative & business excellence.

We bring you a team of professionals who are:

  • Encouraged in coding software such as EncoderPro, FLashcode, CodeLink, etc.,
  • Apply conventional CPT, HCPCS method and supply codes, and ICD-CM diagnosis coding as per guidelines
  • Vital in processing medical bills with driving popular carriers such as United health, WellPoint, Humana, HCSC, etc.

With outsourcing medical billing and coding, physicianscan benefit from expert support for ICD-10 coding, electronic request submission, denial administration, payment posting, groups, and continual follow-up on unpaid and underpaid claims. It is the most reliable way to take care of the business aspect of their practice. In such companies, the expert billing staff is educated about complicated gastroenterology billing codes and conventions, gastroenterology-related specifications, coding for surgical procedures, and code modifications compared to various procedural practices. They also hold up to date on payer rules and laws. Such expertise will go a great way in ensuring error-free coding and claim submission for maximum reimbursement.

Let us know what you need!