We know your Gastroenterology specialty, let us help you build your business.
Medical billing and coding for gastroenterology services can be challenging and requires extensive knowledge and gastroenterology-specific billing expertise.
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.
Our team of certified coders have the kind of experience necessary to ensure your GI practice will maintain consistent cash flow while increasing collection rates. All of our coders are certified either through the AAPC or AHIMA and uphold the ethics and standards of the profession. Additionally, our billers and coders work directly with your staff to learn the nuances of your practice so as to be aware of known issues. They will provide feedback on coding scenarios that need attention and possible correction.
What we know…
Within the insurance industry, the regulations put forth by the Affordable Care Act provide 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.
Various office services provided, ie: Capsules, Bravo Tests, H-Pylori testing, along with your regular office visits and consults combine to provide effective patient treatment for gastric problems. Correct coding and billing for all of these services is key.
Practicing GI providers perform multiple procedures and treatments, which will generate an abundance of claims, involve multiple payors and can result in a myriad of claims issues. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Here are some of the complications that are affecting GI revenue collection procedure:
GI providers who treat patients within hospital services are at risk for missing billings due to difficulties in tracking services. We have established mechanism for ensuring the capture of your charges
Incorrectly bundled payments
Not collecting the proper co-pays at the time of service
ICD10 codes that are not covered under the LCD’s for your area
Billing screening colonoscopies instead of a diagnostic and vice versa
On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We have a 98% first time clean claims rate so we’re always on top of all the latest coding and billing updates for GI practices. To make sure claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date of what is happening in their practice so that any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package