Gastroenterology or GI practices deal with several expensive procedures like endoscopies, colonoscopies, liver biopsies, etc. Hence, GI practitioners must ensure timely reimbursement to maintain a healthy cash flow. With all the insurance rules and paperwork, it often feels like chasing payments never ends. Delayed payments, denied claims, and confusing insurance rules can really complicate the entire process.
Here, experienced GI billing services offer welcome relief. For GI practices, billing isn’t just paperwork—it’s the backbone of financial health. The GI billing services handle everything from coding claims for a routine endoscopy to chasing down payments from insurers. Hence, with the right GI billing services, practices can eradicate hectic erroneous billing and keep money flowing steadily.
Simplifying GI Billing Procedures to Keep Healthy Cash Flow
When billing goes wrong claims get denied. In most cases, a tiny coding or documentation mistake leads to denials. Consequently, practices end up losing money and wasting time trying to fix things. Although GI billing is a pretty intricate procedure, with expert’s intervention it can be simplified and streamlined. Here is how –
• First off, before any gastroenterology procedure, billing specialists must check the patient’s insurance coverage. In many cases, gastroenterologists find the patient’s insurance plan isn’t active. Also, in some cases, patients have already availed of their insurance benefits or the treatment isn’t covered under their plans. Hence, GI billing services must check with insurance companies to confirm coverage.
• After that, billing staff must apply for prior authorization from the patient’s insurance payer. They need to submit a pre-approval request justifying the medical necessity of the prescribed gastroenterology procedures or tests. If the payer considers the treatment necessary, they will approve the cost. It is a significant step, as successful prior authorization guarantees timely reimbursement if practices don’t commit further billing, coding and documentation errors.
• Moreover, billing specialists must enter accurate medical codes and documentation. Every GI procedure has its own code. If that code is wrong, insurers will immediately reject the claim. Hence, practices should make sure their billing team knows the latest rules from the American Medical Association (AMA). Doing regular checkups on coding helps catch slip-ups early.
• Next, Gastroenterology billing services must submit the claim within the TFL (Timely Filing Limit). For Government insurers like Medicare and Medicaid, TFL is 1 year. For most commercial insurers, TFL is 90 days. Most professional billing specialists submit claims as soon as the treatment is rendered. The quicker claims go out, the quicker money comes in. Moreover, it provides them with the required time to appeal if the claim gets denied.
• Furthermore, when a claim gets rejected, billing staff must thoroughly detect the reasons for the denial. Maybe it’s a coding error or some paperwork got lost. They must rectify the claim at the earliest and resend it within the appeal TFL. Denial management is a significant responsibility of billing specialists. If they can get approval for the denied claim faster, the practice can keep its revenue cycle shorter.
When billing runs smoothly, the benefits ripple out. Doctors can spend less time stressing about finances and more time with patients. Also, staff aren’t overwhelmed by constant fixes, so they can plan to further improve their patient care.
Contact Experienced Outsourced GI Billing Services to Optimize Reimbursements
Finally, expert GI billing and coding specialists aren’t easily available. Moreover, they are significantly expensive. Hence, maintaining internal billing specialists will not only expose the practice to administrative workloads but also drain their revenues. Here, hiring expert outsourced billing specialists is the best and most cost-effective option.
As per our observation, third-party GI billing specialists cut about 80% of operational costs. Also, they ensure 100% billing accuracy. Hence, with their assistance, GI practices can experience healthy cash flow. Moreover, outsourced billing experts look after end-to-end revenue cycle management. It allows gastroenterologists to put all their attention into improving their healthcare services. This way, they not only boost their financial health but also ensure better patient outcomes.