Choosing a billing partner for accurate Gastroenterology coding is difficult. You need to have a medical billing company that comprehends complicated gastroenterology billing codes and guidelines, Gastroenterology-related terminology, coding for surgical procedures, and code variations associated with numerous procedure rules.
Also, the denial process and skill to appeal denied claims efficiently and quickly to ensure swift reimbursement. As we point out throughout our site follow-up is what makes a real difference when it come to your practice getting its maximum receivables.
Detailed Gastroenterology Medical Billing
There are numerous CPT codes and conditions to deal with in order to correctly submit your claims. Depending on your practice, you may need to bill for office services as well as ASC procedures and hospital visits and procedures. Due to these complexities, Gastroenterology coding is difficult and calls for an advanced level of understanding to ensure optimum reimbursement. These difficulties include things like billing for colonoscopies as opposed to colorectal cancer screenings, GI function and motility studies, recording appropriate Evaluation and Management Services levels, and utilizing modifiers 26, 59, and 51.
Additionally, endoscopy and gastroenterology billing requires the skill to successfully monitor underpayments. This condition typically exceeds the functions of common medical software and medical billing personnel. Those GI specialists not properly focusing on underpayments commonly see a 7%-10% decrease in levels of revenue.
PHR is knowledgeable both in endoscopy and gastroenterology billing. Our staff of certified coders and medical billing professionals will work in partnership with your practice, ensuring that you collect the greatest reimbursement. Medical Billing Solutions, Inc. will identify trouble areas including the appropriate modifiers usage, underpayment evaluation, and manage every aspect of your practice’s billing. For more information on billing solutions for the specialty of gastroenterology, request a complimentary demo or contact us for additional information.
To succeed in the ever-changing billing scenario in the specialty of gastroenterology, you need extensive knowledge in coding and a skilled gastroenterology medical billing team to assist you. In addition to the diagnosis and treatment of gastrointestinal and hepatological diseases, practices may have sub-specialty areas such as bowel diseases, therapeutic endoscopy, gastrointestinal cancer and its prevention, endoscopic surveillance, pancreatic disease, clinical nutrition, and transplantation. With extensive experience in providing gastroenterology medical coding and billing services, Outsource Strategies International (OSI) can ensure accurate claim submission processes to maximize your revenue.
Our HIPAA compliant gastroenterology medical billing company provides customized and affordable billing solutions for individual physicians, group practices, clinics, hospitals and ambulatory surgical centers.
Common Billing Issues
Gastroenterology is one of highest volume ambulatory surgery center specialties and over time PHR has found repetitive issues with the following:
- Modifiers. One of the most common GI/endoscopy coding mistakes is caused by confusion between modifiers 51 and 59. Modifier 51 is used for two procedures in two different coding categories being performed on the same day, for example EGD and colonoscopy, according to the ACG. They recommends listing the code with the greatest value first, as the multiple procedure rule applies. Modifier 59 is utilized when a different procedure is performed or a different site is addressed on the same day, which would not normally be done.
- Upcoding – New patients associated with higher reimbursement rate E/M codes than established patients due to greater time requirements, according to the Centers for Medicare and Medicaid Services. Upcoding can occur when a follow-up visit with an established patient is coded at a level corresponding with a new patient office visit.
- CPT Updates – The American Medical Association 2014 CPT Code set includes more than 300 changes, 84 of which affect GI/endoscopy. Physicians and coders need to be aware of updates to avoid denials.
- The Affordable Care Act provides Screening Colonoscopies at no charge to the patient once every 10 years. Proper coding of these services will help to minimize confusion for your patients as well as allow for correct payments for your services.
PHR Stays on Top of Your Gastroenterology Billing
Our team has the kind of experience necessary to ensure your GI practice will maintain consistent cash flow while increasing collection rates. Preferred Health Resources offer a three-dimensional sphere of medical billing specialties that provide comprehensive support for the busy gastroenterology practice demands his or her attention 24 hours a day, seven days a week. In addition to professionally and accurately submitting all your claims, Preferred Health Resources also provides the following services for one, performance-based fee:
- Personal responses to all patient billing questions
- Generation and mailing of patient statements
- Rapid posting of reimbursements
- Customized monthly statistical reports and spread sheets tracking business activity and productivity
- Application of effective collection procedures to promote remittance of outstanding receivables
- Collection and analysis of patient information
- Evaluation and recommendations for fee structuring strategies
- Over 1,200 different type of reports are available to all practices
Your practice wants and receives highly accessible use of an account representative that understands your practice inside out. You and you ought to anticipate your bill service customer support section and immediate accessibility, respectively in the event of crises.
As one of the most unique and distinguished medical billing companies in the industry, Preferred Health Resources offers thorough solutions to all of your billing needs. For one fee, your gastroenterology practice receive the benefits of working with an experienced medical billing company that takes pride in providing clients with consummate professionals possessing years of experience in the medical billing industry.
Outsourcing medical billing claim submission to PHR maximizes office competency and minimizes the expense of backlogs. Your practice will also no longer have to worry about rising overhead expenses, upgrading computer software, pursuing denial of payment claims or inadvertently violating HIPAA guidelines. Additional benefits provided by Preferred Health Resources include:
- Assignment of a personal account executive
- Personal response to questions (no voice recordings)
- Daily submission of claims electronically
- Productive and assertive follow-up on all claims
- PHR will bill off of your EMR or billing system.
For a Free Consultation Call
Experiencing significant loss of revenue due to billing issues is both unnecessary and rectifiable. PHR’s experienced staff of authoritative medical billing and claims processors are always prepared to fight for its clients to get the best reimbursements from all carriers. Let Preferred Health Resources take charge so you know your claims are being managed professionally and with a personal touch.