Results-Driven Gastroenterology Billing Services
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Overview of Gastroenterology Billing Services
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.
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.
Managing 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.
Mitigating 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 MediBill MD
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 MediBill MD, 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 MediBill MD, 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 MediBill MD, 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 MediBill MD
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 | MediBill MD 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, MediBill MD’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 MediBill MD, 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. | |
Why pay more when you can get the same quality of service at lower rates? Partner with MediBill MD and get customized billing services for your gastroenterology practice at unbeatable rates.
Price Comparison Calculator
Based on your annual collections, we will calculate the in-house medical billing cost and compare it with the MediBill MD service charges.
Get In Touch With Our Gastroenterology Billing Experts
Are you ready to experience the MediBill MD difference? Contact our expert gastroenterology billing team today and see them reclaim your lost revenue within a month.
FAQs
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.
