Gastroenterology Billing Company, GI Billing Services in New York

Gastroenterology practices sit at a tricky crossroads: high-volume preventive services, complex therapeutic procedures, and payer rules that change just often enough to trip you up. Eventually, the result shows denials that drain cash flow and burn staff time. The good news is that most denials follow predictable patterns. Tackle the top offenders with clean documentation and tight front-to-back processes, and you’ll see fewer write-offs and faster payments. Here is some common gastroenterology billing denials with effective solutions. 1) “Medical necessity not supported” Why it happens: The claim lists a CPT/HCPCS code, but the diagnosis codes and notes don’t clearly tie the procedure to a covered indication. Solution: Gastroenterology billing services should first match indications to payer policies. They must make sure symptoms (e.g., GI bleeding, iron-deficiency anemia) or risk factors perfectly align with coverage criteria. In the op note, the billing staff spell out the clinica...

We all know that prior authorization is a utilization management process that protects your patients from expensive treatments and diagnostics, and ensures coverage for you. However, prior authorization in gastroenterology billing services often becomes a roadblock, delaying patient care and eating up a chunk of your revenue. You might have already realized that an inefficient prior authorization ruptures your bottom line, but have you ever wondered how? Well, it's time to know why it is still a big deal and damages your overall revenue. Know why PA is a big deal in gastroenterology billing services Gastroenterology involves many tests and procedures, like colonoscopies, endoscopies, and capsule endoscopies, most of which need prior authorization before scheduling. You either perform the procedure without coverage, risking non-payment, or delay it until the insurance approves, when you miss PA approvals. Both hurt your practice—one directly impacts your cash flow, while the other ...