The Gut Check on Billing: Innovative Medical Billing Solutions for Gastroenterologists

Like most professionals in the medical field, gastroenterologists must complete more than a decade of schooling and training just to have a shot at entering one of the most competitive specialties in medicine. 

Here’s a look at what that journey usually consists of: 

  • 3-4 years of undergraduate studies
  • 4 years in medical school
  • A one-year internship
  • 2-6 years of residency training
  • A one- or two-year fellowship

It’s not an easy journey and it certainly takes a lot out of you, but all that time, energy, and effort pays off because it teaches you almost everything you need to know to be successful in the gastroenterology field.

Of course, the key word there is almost

While medical school can teach you enough about the digestive system and GI tract to detect, diagnose, treat, and prevent gastrointestinal diseases, there’s one thing medical school doesn’t prepare you for.

And it’s this crazy little thing called medical billing

Medical Billing: A Gastroenterologist’s Guide to Getting Paid

I think it’s safe to say that most gastroenterologists treat their job less like a profession, and more like a passion. In other words, it’s something they do because they enjoy it – not just because they’re good at it.

But no matter how passionate they are, gastroenterologists don’t work for free. 

Whether they’re billing the patient or an insurance company, GI doctors need to get paid for the services they provide – otherwise, they won’t have the income or revenue to continue serving their community. 

Don’t worry – that’s where medical billing comes into play. 

Medical billing refers to the process of invoicing patients, submitting insurance claims, posting payments, and maintaining patient records to ensure gastroenterologists are reimbursed for all of their hard work. 

Billing Bellyaches: Common Billing Challenges for GI Doctors

When most of us schedule an appointment with a doctor, we’re often too distracted by our symptoms or condition to consider how (and when) our doctor gets paid for services rendered during the appointment. 

The truth is it could take weeks, months, and even years before they see any type of reimbursement

Here are some of the most common reasons why: 

  • Claims keep getting rejected or denied due to typos and errors. 
  • Claims aren’t getting submitted (or approved) in a timely manner.
  • Gastroenterologists are too busy talking to patients to gather codes. 
  • Patient information gets inputted incorrectly. 
  • Uninsured patients aren’t paying their bill in a reasonable timeframe. 
  • Failure to record time units properly. 
  • Failure to bundle services when necessary or applicable. 
  • Failure to obtain pre-authorization or referrals when required.

Even when payments are received in a timely manner, the medical billing process is far too complex and often takes too much time, energy, and effort that could be spent talking to and dealing with patients. 

Gut Instincts: How to Cure Your GI Practice's Financial Woes

Medical billing is an intricate process that requires an extensive amount of experience, knowledge, and persistence. The problem is most gastroenterologists are too busy to handle this process on their own. 

Don’t worry – that’s where we come into play. 

At Millenium Medical Billing, we have an unquestioned amount of experience working with people like you – and clinics like yours – and we can’t wait to extend our expertise and passion to you and your clients. 

Our goal is simple: to get you paid as quickly – and error-free – as possible. 

Here’s how we do it!

1. Patient Information & Insurance Coverage

The medical billing process begins the moment your patient walks through the front door. If it’s their first appointment with you, they’ll need to fill out a series of paperwork so you can gather their information. 

That includes their name, date of birth, address, phone number, email, and the HIPAA consent form. 

Of course, your receptionist also needs to gather their insurance information – without it, your medical billing team will have no idea what services are covered by their insurance plan, and which ones aren’t. 

2. ICD Codes, CPT Codes, & HCPCS Codes

The next step is figuring out what services were performed during the appointment, and gathering the right medical codes for each service. Unfortunately, this is where a lot of gastroenterologists go wrong. 

There are three primary code systems used by insurance companies today: 

  • ICD codes were developed by the World Health Organization (WHO), and are used to identify the condition being treated.
  • CPT codes were developed by the American Medical Association (AMA), and help identify the different treatment methods used.
  • HCPCS codes were developed by the Centers for Medicare and Medicaid Services (CMS), and are primarily used for Medicare and Medicaid plans.

One of the biggest problems GI doctors face is how often these codes are changing. For example, ICD codes are scheduled to change in 2025 and CPT codes are updated on January 1 every single year. 

3. Accepted, Denied, & Rejected Claims

The next step in the medical billing process is creating the superbill – which is the invoice you send to the insurance provider. The superbill should contain all services performed, and their corresponding codes. 

Once reviewed by the insurance provider, one of three things will happen: 

  1. If the claim is accepted, then it has been approved and your practice will be reimbursed.
  2. If the claim is denied, then the superbill contained an error, typo, or inaccurate patient info.
  3. If the claim is rejected, then the insurance provider is refusing to reimburse the doctor. 

At Millenium Medical Billing, we pride ourselves in maximizing the amount of accepted claims, minimzing the amount of rejected claims, and ensuring denied claims are resubmitted ASAP to avoid further delays.

4. Collections, Patient Statements, & Overdue Payments

If your patient doesn’t have insurance, or if the services you offer aren’t covered by their insurance, then the patient is fully responsible for reimbursement and the remaining bill must be sent to them immediately.

At that point, it’s your medical billing team’s responsibility to monitor that invoice. 

In a perfect world, the patient would pay the invoice upon receving the bill. Unfortunately, that’s not always the case and many patients are unable to pay right away – causing even more of a delay. 

You can simplify this process by giving your patients a variety of ways to pay and offering payment plans to help ease the up-front cost. Giving them access to a payment portal can also encourage swift payment.

Contact Millenium Medical Billing for Immediate Assistance

Is your gastroenterology practice drowning in debt? Are billing problems resulting in cash flow issues? Do your claims keep getting denied or rejected? Does medical billing feel like a punch to the stomach? 

If you answered ‘yes’ to any of those questions, then you’ve come to the right place. 

Welcome to Millenium Medical Billing

With us by your side, medical billing is a thing of the past – it’ll still exist, but we’ll take all that weight off your shoulders, that way, you can focus your time, energy, and effort on what’s most important…

Your patients.

Feel free to contact us today to learn more about the medical billing process and how we can help you get paid on time. Your patients need your full and undivided attention – so help us, help you, help them.