GI billing can get complicated quickly.
A screening becomes diagnostic. A polyp is removed. The technique changes the code. The physician and facility portions need to land in the right place. Those details matter.
VeroRCM manages billing for independent gastroenterology practices inside the systems they already use.
A screening colonoscopy and a diagnostic colonoscopy do not always bill the same way. What was scheduled, why the procedure was performed, and what was found can affect how the claim should be handled. Getting that wrong can create a payer problem or an unexpected patient balance.
Technique matters. Snare, forceps, ablation, and other approaches can have different coding implications. We bill based on what the medical record supports.
Office, hospital outpatient, and ASC procedures can involve different billing arrangements. The professional and facility portions need to be handled correctly, along with the appropriate place of service.
Who provided the service and what is documented can affect how that portion of the encounter is billed.
ERCP, EUS, and other advanced procedures bring additional coding, documentation, and bundling considerations. The same principle still applies: the claim should reflect what actually happened.
Issues around screening versus diagnostic intent, medical necessity, authorization, documentation, or coding.
Harder to see because the payer sent money. It just may not be the right amount.
Starts building when these claims are not resolved quickly.
Vero works across all three.
Your practice does not need an EHR migration to work with us.
We work with major systems including Athenahealth, eClinicalWorks, Tebra/Kareo, AdvancedMD, NextGen, ModMed, DrChrono, Practice Fusion, and others.
Depending on the practice, GI billing may include office visits, screening and diagnostic colonoscopy, upper endoscopy, polyp removal, and more advanced procedures.
See also cardiology medical billing and full-service medical billing.
If you already have a billing company, that is fine. Our Revenue Leak Audit can give you another view of the claims and help identify anything that looks worth investigating.