How Gastroenterology Billing Company Solves Coding Challenges

Though the requirement for gastroenterology is growing in the US, most of the healthcare providers are finding difficulties in coding for these specialties. Coding is an important aspect in gastroenterology billing. It has been observed that there are two aspects contributing to coding, which are proper documentation and coding process. The healthcare regulations are always changing in the US. That's why the healthcare staff cannot learn about all the latest regulations. So, what can be done in this situation so that no claim denial occurs? That’s where the outsourced gastroenterology billing company comes in, to streamline this process. Coding modifiers portray an essential role in accurately describing specific changes. Here, modifiers like modifier 25 and 59 can be beneficial to identify the difference in the same procedure. That’s where the coders come who understands how to use modifiers to improve coding precision. They make sure all the ICD, CPT and HCPCS codes are perfectly used to make sure no claim denial occurs. Apart from that, they also help with streamlining the prior authorization process. But what are the specific coding issues they solve? Let’s dive into this problem.

Top 4 Coding Errors Solved by Gastroenterology Billing Company

It has been identified that there are four common errors in gastroenterology coding. And these issues are distinguishing among diagnostic and screening procedures, coding for multiple procedures, managing coding changes and finally, managing the payer-specific guidelines.

Differentiating Between Screening and Diagnostic Procedures

One of the main issues in gastroenterology billing is differentiating between diagnostic and screening procedures. The diagnostic procedures are used to identify the relevant conditions. Moreover, screening procedures incorporate preventive measures which are being done on asymptomatic patients. That’s where the gastroenterology billing company comes into the picture. These experts know all the complex nuances of all these procedures to streamline the claim submission process.

Coding for Multiple Procedures

Gastroenterology practices have some cases where a single patient visit can involve multiple procedures. The coders need to be cautious while coding for these cases. That’s why thorough documentation about each procedure is extremely important. You need to include all the details such as indications, findings and complications. To be that precise, you need to conduct training workshops regularly with the coders. But your healthcare staff don’t have the time for this. That’s why you need an outsourced company that knows all the intricate details of coding for multiple procedures.

Navigating Coding Guidelines

Different insurance companies have different guidelines, regulations, policies and coverage. But the issue is again the healthcare staff don’t have the time to know all the latest payer policies. So, what can you do in such a case? That’s where you can get the help of an outsourced gastroenterology billing company. These experts regularly review payer contracts, policies and updates. Hence, it is helpful to maintain clear communication with the insurance companies to make sure no claim denial occurs. That’s why you need the help of the outsourced companies to streamline the billing process.

Managing Latest Coding Guidelines

The healthcare regulations are continuously changing. It is because new diseases are coming each week. However, the healthcare staff performs all the administrative tasks along with patient care. So, that’s why they don’t get the time to stay updated with the latest coding guidelines. On the other hand, the outsourced companies stay updated with all the latest coding changes. Moreover, these companies also conduct training sessions to make sure the coders stay up to date. So, that’s how they streamline the coding process to reduce claim denials which eventually reduces the AR bucket.

How to Choose the Right Company?

These outsourced experts comes at a much lesser cost compared to the in-house team. It is because you don’t have to train them and also buy expensive office space for them. Apart from that, these outsourced companies first verify patient eligibility. Then collect important patient documents. Finally, they streamline the prior authorization process to make sure no claim denial occurs. Furthermore, they have knowledge of using latest technologies to reduce claim errors. They also know how to work with the electronic prior authorization process. But, before hiring them, you need to check certain factors to check if they are the right fit for your clinic or not.

Check if the companies help with new patient entry, eligibility and benefit verification, medical coding, prior authorization, payment posting, AR follow-up, denial management and customer service. Moreover, these companies can reduce your operational costs by 80%. They have over 100’s of client references and offer the highest productivity metrics in the industry. These companies can reduce AR bucket by 30% within one month and they also provide dedicated employees operating across different time zones. Apart from that, these companies don’t have any FICA, paid holidays and medical benefits. They also don’t have any binding contract. So, if you want to streamline your billing process, you may consider outsourcing a gastroenterology billing company for this task.