Gastroenterology is a specialized branch of medicine dedicated to the digestive system and its disorders. Its primary focus is on maintaining digestive health and effectively managing gastrointestinal diseases. To ensure a compliant and financially successful practice, gastroenterologists must stay updated on coding guidelines and payer-specific protocols.
We streamline gastroenterology insurance billing for practices by implementing a comprehensive, efficient process that integrates advanced technology and specialized expertise. This covers simple to complex procedures such as endoscopy, colonoscopy, diagnostic testing (X-rays, ultrasounds, blood tests, etc.), transjugular intrahepatic portosystemic shunt (TIPS), endoscopic retrograde cholangiopancreatography (ERCP), etc.
Our expert gastroenterology billing services help practices generate maximum and timely revenue by:
- Collecting comprehensive patient details, including demographic information, insurance coverage, and medical history.
- Verifying patient insurance details to confirm coverage and obtain necessary pre-authorizations for procedures.
- Assigning specific codes for claims submission across a variety of gastroenterology procedures, including endoscopy (colonoscopy, EGD, ERCP, EUS), pathology and biopsy, therapeutic procedures (polypectomy, EMR, ESD), capsule endoscopy, motility testing, and conditions like hepatitis, gallstones, gastritis, GERD, IBD, and IBS.
- Adhering to AAPC-mandated code specificity, using ICD-10-CM codes for gastroenterology diagnoses and examinations, the 91010-91322 CPT code range, HCPCS codes, endoscopy codes, biopsy codes, evaluation and management codes, polypectomy codes, and relevant modifiers such as -51, -59, and -26 to ensure GI billing and coding accuracy.
- Preparing and reviewing claims to ensure correct coding and documentation, and submitting them to insurance companies.
- Overseeing the generation of clear and comprehensive reports, detailing charges, authorized amounts, deductibles, copayments, and coinsurance for each patient to prevent unpaid bills.
- Monitoring the status of submitted claims, and identifying and addressing related issues promptly after claim submission.