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Tailored Gastroenterology Medical Billing & RCM Solutions
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Gastroenterology Billing Services We Offer
For a medical specialty whose practitioners are high in demand but low in supply, a 64% burnout rate seems justified. The biggest contributor to gastroenterologists' burnout is bureaucratic tasks like medical billing and coding. From checking patients’ records to filling out forms and processing claims to filing appeals, steps associated with gastroenterology medical billing can eat up hours of the provider’s day.
Outsourcing gastroenterology billing services to professionals not only reduces burnout. It is an all-in-one formula that ensures gastroenterology billing and coding accuracy, regulatory compliance, effective patient and payer communication, and revenue cycle optimization under one roof.
Streamlined Gastroenterology Revenue Cycle Management
You don’t ever have to worry about digesting denials. MediBillMD’s complete gastroenterology revenue cycle management (RCM) simplifies insurance billing, ensures compliance, and maximizes collections to enhance our partnered healthcare practices' operational efficiency and financial performance.
Our gastroenterology RCM experts carefully study each step of the cycle to reduce billing errors, file accurate claims, prevent denials, and increase the cash flow so patients continue to receive quality healthcare without financial constraints disrupting the care delivery. We understand that gastroenterology practices’ RCM challenges are unique and more complex compared to other specialties. That’s why our solutions target long-term success through data-driven insights.
Verification & Pre-Authorization
Don’t waste your time and resources on non-revenue-generating services! At MediBillMD, we hit the brakes before you render non-covered or unauthorized services to your patients. Our team carefully verifies each patient’s insurance eligibility and benefits and obtains preauthorizations when needed to prevent payment denials.
Accurate Data Management
Get all your billing data in one place for quick and easy access! At MediBillMD, we effectively manage patient data through integrated EHRs/EMRs to ensure accurate information is entered on the claims each time. It allows us to maintain comprehensive documentation, which can later be used as evidence to fight claim denials.
Automated Workflows
Supercharge your revenue cycle with smart technology! At MediBillMD, we combine human expertise and advanced technology to optimize gastroenterology revenue cycle management. Our team uses industry-leading tools and software to automate repetitive tasks, eliminate errors, expedite claims submission, and improve collections.
Diligent Claim Scrubbing
Detect and correct mistakes before submitting claims to the payers! At MediBillMD, we partner with the best clearinghouses to get the claims scrubbed for errors before they are sent to the insurance payers for processing. It prevents denials and saves everyone from the hassle of reworking and resubmitting claims.
Tracking & Follow-Up
Keep an eye on the status of your claims to get every dollar you deserve! At MediBillMD, we chase payments through diligent tracking and continuous follow-ups. Our team monitors the status of submitted claims to detect denials early on and reaches out to the payers and patients, reminding them of unpaid claims.
Security & Compliance
Optimize your revenue cycle through secure and compliant billing! At MediBillMD, we abide by the HIPAA security rules and follow strict protocols to safeguard our clients’ and their patients’ sensitive information. Our gastroenterology RCM processes are compliant with the payer policies and state and federal regulations.
Effective Communication
Say what matters and when it matters to avoid payment disputes! At MediBillMD, we maintain effective communication with the key stakeholders, whom we refer to as the 3Ps – Patients, Providers, and Payers – to ensure the right people are billed and paid. Our team has separate communications channels for each.
Performance Analysis & Reporting
Identify patterns and revise workflows to improve the financial performance of your practice! At MediBillMD, we regularly analyze data to spot shortcomings in our billing process. The findings are documented in detailed reports and shared with clients for strategic decision-making and process refinement.
Common Challenges in Gastroenterology Medical Billing
The gastroenterology billing process is intricate, time-consuming, and riddled with obstacles at every step of the way. Slight oversights like typing errors or not entering the required information can lead to payment delays, and grave mistakes like non-compliance, inaccurate coding, or lack of documentation can cost practices their revenue.
Such day-to-day challenges can disrupt the gastroenterology medical billing workflow, bringing the practice’s revenue cycle to a standstill. Gastroenterologists and billing specialists must navigate these common challenges to ensure financial sustainability, operational efficiency, and quality patient care.
Prior Authorizations
While less complicated gastroenterology procedures are covered by most insurance payers, specialized services require pre-authorization. Gastroenterologists must substantiate the medical necessity of the procedure to get prior approval from the payer for rendered care. The wait times for pre-certifications could be weeks, and without it, the claim will be denied.
Ensuring Compliance
Gastroenterology billing may involve filing claims to multiple payers. Medicare, Medicaid, and private insurers cover some gastroenterology services and may reimburse the provider via an arrangement known as coordination of benefits (COB). In this case, the gastroenterologist must follow the billing requirements of each payer to file clean and compliant claims.
Claim Denials
Preventing and managing claim denials can be costly and time-consuming. Even with due diligence, the chances of claim denials are high in gastroenterology because of coding errors, multiple payers, frequently changing regulations and varying requirements. Spending too much time on claim scrubbing could result in late filings and hard denials.
Adapting to Changes
Gasteronology medical billing specialists must also be prepared for frequent changes in industry regulations, payer policies, coding guidelines, and practice management. Not staying abreast with these reforms could result in non-compliance, claim denials, heavy penalties, and reduced patient inflow, all of which could drag a gastroenterology practice down.
Outsource Gastroenterology Billing Services to MediBillMD
They may call you the GI Doctor, but we are GI Joes of medical billing and coding. We defend your gastroenterology practice from crumbling under financial pressures. Whether you need us to formulate strategies for maximized reimbursements or want us to step onto the battlefield and fight claim denials like pros, we are always ready to report for duty.
At MediBillMD, our team of gastroenterology billing specialists includes AAPC-certified medical coders and revenue cycle managers who work day and night to file accurate and compliant claims, reduce AR days, and increase the practice’s cash flow. With our secure, centralized systems, cost-effective solutions, and round-the-clock virtual assistance, we accelerate our clients’ revenue generation and growth optimization
At MediBillMD, we employ an experienced team of AAPC-certified coders. They are trained to handle the complexities of gastroenterology coding and use the latest medical coding standards like ICD-10-CM, CPT, and HCPCS Level II to code gastroenterology diagnoses, procedures, and services to the highest level of specificity.
We are 100% HIPAA-compliant and ISO-certified. Our adherence to federal and state regulations and insurance payer policies helps us maintain the highest standard of quality and deliver secure, error-free and approved gastroenterology medical billing services to our clients.
We guarantee higher profits at lower prices. Our professional gastroenterology billing services are offered at some of the lowest market rates to ensure that you receive the highest return on investment without making a dent in your savings.
At MediBillMD, we use a password-protected centralized system to streamline the gastroenterology billing workflow, maintain detailed documentation, and expedite two-way communication. All the files are end-to-end encrypted and only accessible by our team and clients. It helps us track the progress of claims and reimbursements in real time.
We are solving the GI billing problem - coast to coast! It does not matter if you provide gastroenterology care in a large hospital in downtown Boston or run your private practice as a gastrointestinal consultant in Florence, Oregon, our nationwide reach has got you covered.We have a keen eye for state laws and effectively adapt our gastroenterology billing workflow to align with your requirements.
Overcome Gastroenterology Billing Challenges with MediBillMD
The Medical Group Management Association (MGMA) reports that for gastroenterology, the average claim denial rate is around 6.7%, significantly higher than the median denial rate of 4.9% for all medical specialties. Most of these denials occur because of medical billing and coding errors. From inaccurately reported procedural codes to incomplete documentation, the gastroenterology billing process is met with several challenges.
| Common Gastroenterology Billing Challenges | MediBillMD Solution | |
|---|---|---|
| Missing Referral Letters from Primary Care Physicians | A referral letter from the patient’s primary care physician is required to establish medical necessity for services. During patient scheduling, MediBillMD’s team confirms if the patient has this letter. | |
| Verification of Insurance Coverage for Diagnostic Tests/ Procedures | Insurance payers do not cover all diagnostic screenings. Before scheduling appointments, our gastroenterology billing team verifies the patient’s insurance coverage for the procedure to avoid denials later. | |
| Medicare Local Coverage Determinations (LCDs) and Local Coverage Articles (LCAs) for Endoscopies | Medicare and Medicaid have specific rules for the coverage of capsule endoscopies. We thoroughly assess the patient’s condition to determine whether CMS will cover the procedure. | |
| Reporting Correct CPT, ICD-10-CM, and HCPCS Level II Codes | Gastroenterology services include diagnostic, treatment, and preventative care procedures. Our AAPC-certified coders report the procedural, diagnosis, and medical supplies/services codes to the highest level of specificity for reimbursements. | |
| Delayed Pre-Authorization for Specialized Procedures | The wait times for gastroenterology visits and procedures can be longer than other specialties. At MediBillMD, we fast-track pre-authorizations and secure approvals within 48 hours to enhance patient satisfaction. | |
| Maintaining Paper Trails for Insurance Audits | Insurance payers can randomly audit healthcare providers for billing accuracy and compliance. Our gastroenterology billing team maintains detailed documentation to pass these audits and identify areas of improvement. | |
Lowest Prices Guaranteed
Why pay more when you can get the same quality of service at lower rates? Partner with MediBillMD and get customized billing services for your gastroenterology practice at unbeatable rates.
Get In Touch With Our Gastroenterology Billing Experts
Are you ready to experience the MediBillMD difference? Contact our expert gastroenterology billing team today and see them reclaim your lost revenue within a month.
FAQs
You can call us at (877) 353-9542 or fill out the form at the top of the page to schedule a free consultation. Our representatives will give you a brief billing assessment and guide you through the onboarding process.
MediBillMD’s team diligently monitors the industry trends to stay current with the changing regulations and payer policies. Our gastroenterology billing, coding, and RCM specialists maintain regular and effective communication with the government and private insurance payers, as well as the regulatory bodies, to comprehend the revised quality standards and ensure compliance.
Moreover, we perform regular audits to eliminate outdated or incorrect billing practices and implement processes that align with the latest rules and regulations.
Gastroenterology medical billing is complex due to the variety of procedures, diagnostic tests, and coding rules involved, requiring specialized knowledge and expertise. Medical billers and coders must be adept at CPT, ICD-10, and HCPCS coding, and know the specific billing rules, such as bundled codes in NCCI edits, etc.
With MediBill MD as your trusted gastroenterology billing partner, you can scale the services up or down without worrying about hidden charges, a drop in quality, or account transfers. Our team adapts to your practice’s changing needs and can take on more load as your gastroenterology business grows or trim down services to align with your cost-cutting measures. Simply put, our tailored approach makes us one of the best gastroenterology billing services providers in the medical billing space.
At Medibill MD, we only charge a small percentage of your monthly collections for our professional gastroenterology billing services. Depending on the size of your practice, the services acquired, and the number of claims processed and submitted, we charge between 2% and 5% of your reimbursements.
A majority of the gastroenterology claims are denied because of coding errors. Using the latest and most appropriate ICD-10-CM, CPT, and HCPCS Level II codes can be challenging for the gastroenterology medical billing team, especially when multiple procedures may be performed in a single visit, and the code sets are updated quarterly or annually.
