Gastroenterology Medical Billing Medicare

Gastroenterology Medical Billing Medicare

Gastroenterology is a medical specialty that focuses on the digestive system and related problems. This specialty focuses on illnesses of the gastrointestinal system, which includes the organs from the mouth to the stomach, as well as the organs along the alimentary canal. Gastroenterologists are doctors who specialize in this discipline.

Gastroenterologists must stay current on the numerous coding rules and payer-specific protocols in order to maintain a compliant and financially successful practice. Medical billing and coding in gastroenterology is difficult and necessitates a wide variety of expertise to secure optimal compensation. Billing for colorectal cancer screenings vs. colonoscopies, motility, and GI function investigations, documenting adequate levels of evaluation and management services, category III codes for GERD treatment, and using modifiers -51, -59, and -26 are just a few of the issues. Receiving payment for the services you provide necessitates meticulous attention to detail and constant communication with your whole staffing team, including all providers.

Additionally, invoicing for gastrointestinal and endoscopic services necessitates the capacity to properly track underpayments. Most billing software and in-house billing professionals are unable to meet this need. GI practices that do not successfully target underpayments are at risk of losing a lot of money.

We have a client base at Nixxe MBS that includes hospitals, physician offices (including GI practices), and medical billing organizations from all 50 states. We use our ten years of experience and knowledge working with gastroenterologists to help you fix and improve your revenue cycle. Our coders are qualified by the American Academy of Professional Coders and are familiar with CMS and AMA’s ICD-9/10, CPT, and HCPCS coding rules (AAPC).

Gastroenterology Billing and Coding Services: Best Practices

We understand the complexities of GI medical billing, such as how to bill a colonoscopy with a splenic flexure advancement. Otherwise, the documentation would be lacking and would only allow for a sigmoidoscopy to be performed. Our certified coders are available to you 24 hours a day, 7 days a week to help you avoid problems caused by erroneous modifier use and to teach your in-house billing specialist how to avoid them. Our qualified billing and coding specialists seek to reduce claim denials while improving payouts. This is accomplished by concentrating on effective, streamlined systems that reduce the amount of time required to charge orthopedic services accurately. Our delivery model is based on a solid technological foundation and a staff dedicated to offering data-driven solutions. That results in fewer denials and higher revenue.

Benefits Associated with Gastroenterology Billing

Our Gastroenterology Billing and Coding Services have a number of advantages.

We provide GI billing and coding services with expertise, knowledge, and precision, all while ensuring. A revenue cycle free of errors for your clinic. We can bring value to your company through analytics-driven and result-oriented processing across the revenue cycle chain, including patient demographics entry, insurance verification, insurance authorizations, coding, invoicing, account reconciliation, and rejection management. Our team aims to make the billing, coding, claim submission, and payment posting processes as simple as possible. To avoid claim denials, we maintain constant accounts receivable follow-up and prior authorization. Shifting your focus from denial management to denial prevention is our denial management team’s top priority. Medical Billing Wholesalers assists gastroenterologists in providing exceptional patient care while focusing on administrative and financial excellence. We have assembled a team of experts.

  • Who knows how to use medical billing software from companies like Advanced MD, Athena, CureMD, Office Ally, EzClaim, and others.
  • EncoderPro, Supercoder, CodeLink, and other coding software have been taught to them.
  • As per CMS recommendations, use conventional CPT, HCPCS procedure and supply codes, and ICD-10-CM diagnosis coding.
  • Successfully processed medical bills for major commercial carriers. United Health Care, WellPoint, Aetna, Humana, HCSC, Blue Cross Group, and others.
  • Able to successfully negotiate Medicare and Medicaid policies specific to each state.
  • Our medical billing firm has extensive knowledge of all elements of gastrointestinal billing.

We are well-equipped to deal with all of the intricacies that come with coding, invoicing, and payment. Our billing professionals will ensure. That clean claims are submitted to optimize revenue, and our staff of experienced billers has excellent gastroenterology-specific coding expertise.

OB GYN Billing and Coding Services

OB GYN Billing and Coding Services

Obstetrics & Gynecology is a subspecialty of medicine that focuses on the care of women during pregnancy and childbirth, as well as the diagnosis and treatment of illnesses of the female reproductive organs. Additionally, it focuses on other aspects of women’s health, such as menopause, hormonal imbalances, contraception (birth control), and infertility.

An OB/GYN practice performs a variety of operations, including surgeries, pre-and postnatal care, and routine health checks for women.

Expertise in OB/GYN Billing & Coding Medical Billing Wholesalers

At Nixxe MBS, our client base spans all 50 states and includes a diverse spectrum of hospitals, physician offices (including OB/GYN clinics), and medical billing firms. Our team of OB/GYN billers and coders leverage their experience and knowledge gained from working with obstetricians and gynecologists for the purpose of increasing revenue and driving growth. Nixxembs coders are certified by the American Academy of Professional Coders in ICD-9/10, CPT, and HCPCS coding rules supplied by CMS and AMA (AAPC). Our billing and coding expertise in OB/GYN includes the following specialties:

  • Obstetrics and Gynecology
  • Endocrinology of the Reproductive System and Infertility
  • Uro-gynecology and Pelvic Reconstructive Surgery Gynecological Uro-gynecology and Pelvic Reconstructive Surgery
  • Laparoscopic Advanced Surgery
  • Planning a Family
  • Gynecology in Children and Adolescents
  • Gynecology in Menopause and Geriatrics

Adhering to industry standards for OB/GYN billing and coding services

At Nixxe MBS, we understand the difficulties that OB/GYN clinicians encounter, including rapidly changing policy requirements, ICD revisions, and the sensitive nature of your specialty. Our certified coders are capable of selecting appropriate codes based on operative reports from actual surgical cases. We are available to you 24 hours a day to help you avoid problems caused by erroneous modifier usage and to teach your in-house billing professional how to avoid them.

OB GYN Billing and Coding Services

OB GYN Billing and Coding Services

Our specialized billing and coding staff works to minimize claim denials while improving payouts. This is accomplished through the use of effective. Streamlined methods that reduce the amount of time required to accurately bill for Ob/Gyn services.

Our strategy is based on strict adherence to coding standards and best practices, as well as the use of modern technologies. The MBW team is committed to providing data-driven solutions that aid in the reduction of denials and the growth of revenue.

Pros of Using our Facilities

OB GYN practitioners see a large number of patients, some infrequently, such as for yearly checkups, and others on a continuing basis for prenatal care and postpartum care. This requires medical coders and billers to be proactive in processing numerous claims and to understand all the components of bundled claims in order to avoid over or under coding, which not only results in charging too much or too little, but also constitutes a violation of the law and can be disastrous for a practice.

  1. Coverage Is Extremely Diverse

Obstetrics and gynecology are two of the most frequently excluded or limited fields of medicine from insurance coverage. Many have elaborate regulations indicating which items are covered and which are not. This is something that should be clarified before the patient schedules. An appointment to avoid any unexpected costs being issued to them later.

  1. Numerous Facilities

A practitioner may visit the same patient in the clinic and in the hospital, necessitating meticulous coding for each. Billers must understand which procedures are billable in certain circumstances and ensure that everything is documented properly.

  1. Claims at the global level

Certain payers and insurers combine care provided during pregnancy and childbirth into a single claim, which means the practitioner must provide nine months of service before being paid, and each claim is for a significant value, making it critical that claims are not rejected or refused.

Why are we here?

Our obstetrics and gynecology billers and coders would initiate a follow-up on patient claims that have been pending for more than 18 days and optimize your current cycle to 21 to 25 days, depending on the type of insurance accepted by your clinics, using their accumulated knowledge of the following:

  • Coding accurately on the ICD 10 and CPT platforms
  • Printing and distributing paper and electronic bills
  • Pursuing unpaid and outstanding claims
  • Pre-authorization for approaching operations is being worked on.

Some Important Highlights of OB/GYN Coding and Billing Services

  1. J2675 (Injection, progesterone) is a frequently used HCPCS code in OB/GYN, generating significant money for physicians.
  2. Reimbursement for HCPCS codes G0101, Q0091 is permitted just once per year, except in cases of medical necessity.
  3. To be reimbursed for CPT code 59514 (Cesarean delivery alone). An assistant surgeon must be present, as this is a highly compensated and complicated procedure.