Gastroenterology Medical Billing & RCM | Dr Care MSO

GI 3D icon Gastroenterology Billing Services

EGD, colonoscopy, ERCP, EUS-FNA, hemorrhoid banding, PEG, motility studies and capsule endoscopy — accurate coding, fewer edits, faster reimbursements.

Screening vs diagnostic rules, modifier 33, pathology TC/PC splits
Multiple polyps: biopsy vs polypectomy hierarchy, EMR/ESD, clip control
Moderate sedation, anesthesia concurrency, facility coordination
Get Free Audit Talk to a GI RCM Lead
GI billing dashboard with clinician

98%+ Clean Claims

Edits & eligibility checks built in

30–45% Faster AR

Prioritized worklists & SLAs

24–48h Posting

ERA/EOB reconciliation

HIPAA + BAA

Secure workflows & audits

Billing & Coding Built for GI

Our coders interpret op notes, photos and pathology to apply the correct CPT/ICD-10 with payer-ready claims for clinic, ASC and hospital settings.

  • Screening vs diagnostic logic, incomplete procedures, return-to-OR
  • NCCI/MUE edits, multiple lesions, device/supply capture
  • Charge reconciliation tied to endoscopy schedules and pathology
Stomach model on desk
Gastroscopy diagram

End-to-End GI RCM

Eligibility to collections, with dashboards and audit trails.

Eligibility, Referrals & Auths

Benefits checks, referral capture, auth tracking & renewals.

Insurance/eligibility illustration

Coding & Charge Entry

EGD/colonoscopy, ERCP, EUS-FNA, PEG, motility, capsule endoscopy.

Digestive system conditions chart

Claims & Edits

NCCI, MUE, global periods, multiple polyps & bundling logic.

Endoscopy in OR with monitor

Payments & AR

24–48h posting, underpayment detection, AR worklists.

Clinician using digital tools

Denials & Appeals

Root cause, corrective coding, templated appeals.

Blue surgical close-up

Analytics & Compliance

Dashboards, KPIs, audit trails, BAAs & HIPAA controls.

Isometric GI analytics

Payer Nuances We Handle

  • Screening vs diagnostic colonoscopy (modifier 33, cost-share rules)
  • Pathology TC/PC splits and reflex testing documentation
  • Multiple polyps/lesions — biopsy vs polypectomy hierarchy
  • Moderate sedation (intra-service time, same-physician rules)
  • Device/supply capture (clips, dilation balloons, stents)

Denial Prevention & Appeals

  • Front-end NCCI/MUE edits & incomplete procedure logic
  • Eligibility/auth checks with proof on file
  • Appeal templates by payer, timely filing tracking & escalations
  • Underpayment analytics vs fee schedules & contracts
  • Provider feedback for documentation gaps (photos, pathology)

Procedures We Bill Every Day

EGD ± biopsy/polypectomy • Colonoscopy ± biopsy/polypectomy/EMR • ERCP • EUS-FNA • PEG • Hemorrhoid banding • Motility studies • Capsule endoscopy

GI workflow visual
Doctor explaining stomach image
Endoscopy team

GI Billing — FAQs

Do you support clinic, ASC and hospital settings?

Yes — professional claims, facility coordination and endoscopy suite workflows with pathology linkage.

How do you reduce GI denials?

Up-front edits (NCCI/MUE), screening vs diagnostic logic, auth/eligibility verification and payer-specific appeal playbooks.

How fast do you post payments?

Within 24–48 hours with ERA/EOB reconciliation, underpayment checks and payer variance reporting.

Let’s lift your gastroenterology collections

Start with a free claims & A/R snapshot — actionable in 48 hours.

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