How Does Gastroenterology Billing Work? Get The Best Medical Billing Services

Gastroenterology is an area of the medical field that focuses on the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts, and liver. 

Only experienced and highly skilled professionals who understand the nuances of this specialty can offer spot-on gastroenterology billing services. In order to maintain compliance and ensure financial stability, gastroenterologists should stay updated with the latest medical billing and coding standards. 

Moreover, gastroenterology billing specialists should stay well-versed with payer-specific protocols to prepare billable claims.

What Are The Challenges Of Gastroenterology?

It is quite challenging for billing professionals to fulfill the requirements of insurance companies and federal regulations. 

These challenges include billing for colorectal cancer screenings vs. colonoscopies, motility, and GI function studies, documenting proper levels of evaluation and management (E/M) services, category III codes for treatment of GERD, and applying the use of modifiers -51,-59, and -26. 

Gastroenterology billing and endoscopy billing also requires the ability to monitor underpayments efficiently. Missing out on payments also slows your practice’s growth and increases the financial strain. When this requirement exceeds the competency of most billing software and an incompetent in-house medical billing team, you will need a reliable gastroenterology medical billing company that can help you effectively monitor underpayments, file clean reimbursements, and prevent your practice from a massive revenue hemorrhage.  

CureCloudMD is a well-versed medical billing company that offers professional gastroenterology and endoscopy medical billing outsourcing services. Our medical billing and coding specialists work hand-in-hand with your practice to ensure that your revenue cycle management system runs seamlessly. 

We provide a free-of-cost pre-onboarding medical billing audit to analyze errors and mistakes that cause claim denials and rejections in your medical billing system. Moreover, we make sure that your coding practice is accurate and complies with the latest medical coding standards. 

Our billing audit professionals also identify if your coding team is using the correct modifiers, your billing team is evaluating underpayments, and your clerical staff manages all aspects of your healthcare revenue cycle management. 

How Does Gastroenterology Billing Work?

Gastroenterology medical billing process is a completed yet sequential procedure that requires 100% accuracy at every step to ensure that all claims are prepared with error-free billing solutions. 

Collect Patient Demographics

It is important to collect patients’ demographic information accurately. It includes the patient’s name, insurance ID, phone number, residential address, email, and employment information. 

It is the responsibility of gastroenterology billing specialists to ensure that the patient’s demographic information is updated. Sometimes, the patients change their jobs, states, or residential addresses and they forget to inform their doctor. 

Therefore, it is the responsibility of the physicians’ registration staff to complete the paperwork and collect patients’ personal data every time they visit your healthcare facility. 

Otherwise, if the patient has changed their job or employment coverage plan then the healthcare provider will face claim denials from the insurance company. In order to avoid financial challenges, healthcare providers should stay updated with patients’ demographic information and record accurate data in EHR. 

Proceed With Prior Authorization

Prior authorization or pre-certification is a management process used by insurance companies to determine if the prescribed medical therapy or diagnostic test is partly or fully or not covered by them. Several insurance companies require prior authorization in order to approve your claims and give reimbursements. 

Therefore, healthcare providers, doctors, and physicians should have automatic and reliable prior authorization solutions in place that could help them verify if the services delivered to the patients are reimbursable or not. 

Verify Patients’ Coverage Plan Eligibility

Sometimes patients aren’t well-versed in the eligibility criteria of their coverage plan. Therefore, it is the responsibility of your front desk registration staff to verify the patients’ documents and check out if the patient is eligible for the coverage plan. 

If the medical treatment or diagnostic test isn’t covered by the patient’s insurance company then you should ask for your payment from the patient right away. It will improve your patient outcome and help you reduce underpayments. 

Proceed With Medical Billing & Coding:

Gastroenterology is a complex area of the medical field. Professional medical billers should understand the nuances of gastroenterology billing i.e. how to bill a colonoscopy with the advancement beyond the splenic flexure. 

Moreover, medical coders should stay updated with the latest medical codes and compliance regulations. Also, they should prevent problems caused by the incorrect use of modifiers and medical codes. 

Medical coders should also ensure the correct use of ICD-9, ICD-10, ICD-10-CM, CPT, and HCPCS codes in order to prepare reimbursable claims. It can only happen if you can fully focus on efficient, streamlined processes that can reduce your workload and prevent claim denials. 

However, if you’re struggling through staffing shortages or increasing operational expenses then you can also opt for outsourcing gastroenterology medical billing services. 

For that purpose, you should only trust a HIPAA-compliant medical billing company that also has an extensive experience in gastroenterology. 

Follow-up On Medical Bills & Claim Adjudication

Usually, small and medium-sized healthcare facilities don’t have sufficient staff who can follow-up with each submitted claim and make sure that they have fully received their payments. 

In that case, a reliable and professional gastroenterology medical billing company comes in handy. Just like CureCloudMD helps all their clients to receive full payments and avoid excessive delays. 

We commit to follow-up with your each claim from clearing houses to insurance companies. So we can make sure that your claims can get approved and reimbursed on time. 

It is important that someone on behalf of healthcare providers stay fully engaged with the insurance companies and clearing houses. In this way, your claims will be reviewed and scrubbed for adjudication more efficiently. 

CureCloudMD provides full support at this step and our team makes sure that you can get paid for your hard-earned services to your fullest potential. 

Reimbursement Collection and Payment Posting

The last step of the reimbursement model is payment collection. Account managers and medical billers should make sure that the reimbursements are collected and posted in the office’s system. 

What Are The Benefits Of Our Gastroenterology Billing Services?

CureCloudMD provides a complete suite of gastroenterology healthcare revenue cycle management solutions. With our extensive years of experience and specialized expertise in gastroenterology and endoscopy. 

Here’s how you can get the best advantages of outsourcing gastroenterology billing services; 

We Provide A Free Medical Billing Audit To Everyone

Our moto is “Seeing is believing!”, so you shouldn’t miss out on the chance to get a free pre-onboarding external medical billing audit by CureCloudMD. Our professional medical billing and revenue cycle management specialists inspect your entire medical billing procedure from charge entry to payment collection. 

We identify areas of problems including; backlog, data errors, code reconciliation and medical billing procedures to claim adjudication, payment posting and claim denials/rejections. 

We perform a complete external medical billing audit to monitor errors, identify mistakes and resolve compliance issues. It also gives you insights into the requirements of your existing gastroenterology medical billing cycle. 

So you can make a well-informed decision before outsourcing gastroenterology medical billing services. After providing a free medical billing audit, our medical billing professionals provide a custom plan for medical billing services. 

Since medical billing services are not a one-size-fits-all solution, therefore, we provide a custom-tailored gastroenterology medical billing solution. 

After you become our clients, we also provide regular medical billing sessions so you can stay in the know about the progress of your healthcare revenue cycle management system.  

Get A Professional Medical Billing Team

Our qualified medical billing team is well-versed in the nuances of gastroenterology and endoscopy. With our expertise across the revenue cycle chain i.e. patient demographics entry, verification of coverage plan’s eligibility criteria, insurance authorizations, coding, billing, reconciling of accounts, and claim denial management, we provide value-added and analytics-driven medical billing outsourcing services. 

Get Streamlined Medical Billing Outsourcing Solutions

We commit to our clients and help them achieve their financial goals with reliable medical billing services. W provide result-oriented medical billing services to help healthcare providers increase their business growth and reduce account receivables. 

Our team applied friction-free billing and coding solutions to prepare accurate medical claims and process them for reimbursements efficiently. 

We Provide Account Receivable (AR) Recovery Services

CureCloudMD provides two packages of account receivable recovery services i.e. 


  1. Inclusive AR Recovery Services: Along with our medical billing services, we constantly monitor your account receivables and claim denials. We track down your claim denials and appeal them right away. So we don’t let your account receivables age for excessive days. However, we only appeal those payments that remain uncollected at our end. 
  2. Exclusive AR Recovery Services:  

We also provide exclusive AR recovery services to reduce your aging account receivables. It means that you can hire our professional AR recovery specialists to appeal your claim denials/rejections and reduce your account receivables. We only charge a fixed percentage (depending upon your practice’s size) from the revenue we collect on your behalf after appealing your denied/rejected claims. 

In this way, we help you recover outstanding balance with professional expertise and innovative account receivable recovery services.    

Access Certified Medical Coding Team:

Our AAPC-certified CGIC (Certified Gastroenterology Coder)-coders work as a virtual extension of your office team. We professionally communicate with your office staff to collect patients’ information and charge entry to apply accurate codes. 

We Adopt Flexible Medical Billing Solutions

Our medical billing and coding specialists are well-trained and experienced with almost all popular medical billing software solutions including; Lytec, Medic, Misys, Medisoft, NextGen, Kareo, CureMD, and many more. 

We don’t ask you to renew your existing practice management and IT infrastructure. Instead, we integrate our solutions with your existing software solutions to streamline your medical billing system on the go. 

Get Compliant Medical Billing Services

We provide well-encrypted and HIPAA-compliant gastroenterologist medical billing services. CureCloudMD ensures your data integrity and only allows authorized personnel to access your patients’ data and charge entry data to process it further for medical billing and reimbursement collection. 

We apply CPT, HCPCS, and ICD-10-CM codes according to CMS and AAPC guidelines. With a proven track record of successful medical billing with the nation-leading commercial carriers i.e. United Health, WellPoint, Aetna, Humana, HCSC, and Blue Cross Group to name a few, we have helped healthcare providers scale their revenue growth. Also, we comply with Medicare and state-specific Medicaid policies and direct your medical billing system according to the latest updates of the Centers for Medicare and Medicaid. 

How To Outsource Gastroenterology Billing Services To CureCloudMD?

CureCloudMD provides user-friendly medical billing solutions for a wide range of gastroenterology diagnostic and medical services. You can simply click on the following link to reach out to our team: Contact Us 

You can also contact us: +1 205 947 3264

You can tell us your requirements and our team will look into your requirements and walk through your provided information. Our highly responsive team will take one or two business days to contact you and offer custom-tailored gastroenterology medical billing solutions. 

For more information, you can stay tuned with CureCloudMD on social media; 

Facebook: Curecloudmd

LinkedIn: CureCloudMD

Twitter: @curecloudmd

Pinterest: @CurecloudMD


Key Takeaways:

The gastroenterology billing workflow consists of distinct steps and methods that require complete focus and expertise to execute every task properly. Even a slight error at any moment can cause troubles down the line that may end up in your healthcare revenue cycle management in the form of claim denials/rejections. Partnering with a reliable medical billing company can help you reduce work stress and backlog which makes you get desired results from gastroenterology medical billing services. 

Want to outsource gastroenterology billing services? CureCloudMD is a HIPAA-compliant medical billing company that has been helping several gastroenterologists for several years. Contact our team to book a free medical billing audit and outsource medical billing services.  

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