how to reduce denials and increase medical billing for your gastroenterology practice

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How to Reduce Denials and Increase Medical Billing

for your Gastroenterology Practice?

Gastroenterology is a focused field of medical service that has evolved dramatically over

the past few decades. This in effect is a clear symptom of the changing lifestyle of an

average American. Rise in gastric disorders have forced the populace to seek specialized

medical attention and this has increased the focus of healthcare sector on

Gastroenterology practices. With specific medical codes applying to gastroenterology

procedures, billing for a GE practice can be a crucial contributor to clinic profitability.

Statistically, most practices only enjoy a claim settlement ratio of 60%-70% and do not

follow up effectively for the denied claims. This leads to loss of revenue to the tune of

18% -20% for an average GE practice.

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You can reduce claim denials by following these simple steps in your Gastroenterology

Medical Billing Services –

Steps 1 – Monitor claim settlement and rejection ratio First step in addressing

claim denials is generating awareness about settlement ratio of your

Gastroenterology practice. Most GE practices lose a major portion of their

revenue in claim denials and are not even aware of the actual denial ratio. 90%

of the cases denied for claim settlement can be resubmitted and reimbursed by

the insurer with effective follow up in 48 hours. But most GE practitioners fail to

achieve such efficient turnaround time due to lack of records of failed claims.

Thus essentially recording and reporting of claim settlement should happen on a

regular basis.

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Step 2 – Identify cause of denial Once you become aware of the claim denial

ratio of your Gastroenterology practice, the next step is to identify the gaps in

your medical billing companies and establish the causes of denial. Most claims

are denied on grounds of process failure, incorrect coding, incorrect diagnosis or

lack of coverage by insurer. All these problems can be addressed by simply

incorporating required changes in your medical billing process and monitoring

every claim before submission.

Step 3 – Review coding changes for Gastroenterology Gastroenterology

practitioners perform procedures such as gastroscopy, colonoscopy, ERCP,

sigmoidoscopy, etc. In addition to ICD 9 codes, these procedures are also

covered by CPT and HCPCS codes which are updated at a regular interval and the

best way to reduce claim denials is to update your EMR or medical billing process

with current coding changes on a weekly basis.












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Step 4 – Encourage pre-authorization Many insurance carriers require pre-

authorization of service in order for the patient to avail insurance coverage.

Without pre-authorization of procedure, insurance cover providers reject

subsequent claims filed on the grounds of incorrect processing. Therefore, you

must encourage your gastroenterology medical billing team to conduct

preauthorization of each case.

Step 5 – Maintain insurer wise records Your GE practice may be cautious in

monitoring its medical billing but due to versatile payer mix including Medicare,

Federal care, Medicaid and many private insurance carriers it becomes very

difficult to standardize the claim filing and settlement process. Therefore, you

must monitor the revenue contribution and claim settlement procedure of each

insurance provider to integrate changes in your system.











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Medicalbillersandcoders.com is a medical billing expert that can help your GE practice

achieve minimal claim rejection and improve clinic profitability. They offer services of

billing experts who not only understand specific coding requirements of

Gastroenterology but also recognize and fix the causes of claim denials.











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Related Posts:

Boosting Revenues and Avoiding Audits by Streamlining your Gastroenterology

Medical Billing Process

How to Make Billing and Payments Efficient in your Gastroenterology Practice

Benefits of Outsourcing Gastroenterology Billing to a External Company

How to Develop Medical and Billing Practices to Avoid an Audit?

Survive ICD-10 Conversion Risks with Specialized Billing Services

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