Gastroenterology Medical Billing
It is imperative for gastroenterologists to understand the basic concepts of the reimbursement system to maintain a financially stable practice. Details of gastroenterology services are habitually sent to third party payers, otherwise known as insurance companies for reimbursement.
Gastroenterology billing claims, like other medical billing procedures, are sent to the insurance companies in the form of codes to make it more convenient to quantify and categorize the services rendered by the practitioner.
Billing for Colonoscopies, Sigmoidoscopies, and other Procedures
Gastroenterology billing is a sensitive billing process that requires an accurate inclusion of data to get the right reimbursement for the services rendered. This specialty billing exposes the practice to potential losses if the diagnostics and procedures are not properly coded.
Colonoscopies, for example, are at certain times tagged inappropriately as sigmoidoscopy procedures, because the documentation that is written to support the procedure only defines sigmoidoscopy technique. To properly define colonoscopy procedures, it is required for the coder to note the procedure as “advancement beyond the splenic flexure.”
Gastroenterology practices are commonly exposed to underpayments resulting from improper coding procedures. Gastroenterology requires a complex billing procedure that would properly identify the type of procedure done on a patient to ensure a fair and accurate payment.
At other times, gastroenterology’s requirements for billing exceeds what medical billing software can do, and as a result, gastroenterology practices enlist the services of medical billing firms to assist in the practice’s billing procedures.