Gastroenterology
Billing Services

OneMed specializes in gastroenterology billing, one of the most procedure-heavy and modifier-dependent specialties in healthcare. Our team handles the coding complexity, payer rules, and claim precision to keep revenue moving across every encounter.

Skilled Nursing Care

Personal Care

Therapy Services

Medication Management

Companion Care

Let’s Connect

Gastroenterology Billing Structured Around Your Practice

GI spans office consults, diagnostic endoscopy, and complex procedures like ERCP, each with distinct coding. Screening versus diagnostic distinctions alone cause routine denials.

Consults: Office visits are coded cleanly to set up the procedural work that follows.
Endoscopy: Correct setting and modifier applied to stop component split rejections.
ERCP: Prior authorizations are handled before the patient is on the table, then defended on appeal.

Gastroenterology Billing Structured Around Your Practice

Gastroenterology Billing Requires Specialized Expertise

Gastroenterology billing operates under a completely different framework than general medical or facility billing. Our team ensures every claim is accurate, compliant, and supported by the documentation needed to protect your reimbursement.

Accurate CPT coding across diagnostic and screening colonoscopies, EGDs, ERCPs, and capsule endoscopies

Correct application of modifier 33, PT, 59, XU, and 51 across multiple procedure claims

Screening-to-diagnostic conversion handled accurately when polyps or findings are encountered

Anesthesia and moderate sedation billing reviewed for payer-specific compliance

Pathology and biopsy add-on codes captured correctly to avoid revenue leakage

What Our Gastroenterology Billing Services Include

The core billing pillars engineered to capture every dollar your gastroenterology practice earns.

Step 1

Insurance Verification

GI benefits, coverage distinctions, authorization requirements, and network status verified before every scheduled procedure.

Step 2

Endoscopy and Procedure Billing

Endoscopies and GI procedures coded accurately with correct screening or diagnostic designations for reimbursement.

Step 3

Add-On Code and Polyp Removal Billing

Biopsy, polypectomy, and add-on codes captured correctly to ensure all billable services are reimbursed.

Step 4

Sedation and Anesthesia Coordination

Sedation and anesthesia charges coordinated accurately to prevent billing conflicts and support complete reimbursement.

Step 5

Pathology Referral Billing

GI pathology charges coordinated with laboratory billing so every specimen gets billed correctly without duplication or missed charges.

Step 6

AR Recovery and Reporting

Aging GI accounts identified, prioritized, and worked with clear financial reporting delivered to your practice on schedule.

Our Gastroenterology Billing Process

Our billing process is built around the procedural volume and coding precision gastroenterology demands every day.

Charges Received

Procedure reports, sedation records, and pathology referrals are securely submitted through our platform after each procedure session.

Billing Review

Our specialists review screening designations, add-on codes, and sedation charges against payer rules before transmitting any claim.

Claim Submission

Claims are electronically batched and transmitted to payers within 24 to 48 hours of receiving complete procedure documentation.

Payer Follow-Up

We track every claim through adjudication and engage payers directly when processing delays or additional information requests occur.

Denial Management

Denied claims get corrected with supporting procedure documentation and resubmitted through the appropriate appeal channel without delay.

Payment and Reporting

Payments get reconciled and posted accurately, with regular revenue performance reports delivered to your team.

Who We Serve?

The right billing support for every gastroenterology setup.

Independent Gastroenterology Practices

Independent GI providers performing diagnostic and screening procedures who need accurate CPT coding, modifier application, and consistent payer follow-up across every claim.

Independent Gastroenterology Practices

Independent GI providers performing diagnostic and screening procedures who need accurate CPT coding, modifier application, and consistent payer follow-up across every claim.

Ambulatory Surgery Center-Based GI Groups

GI groups performing procedures in ASC settings who need a billing team experienced with facility and professional fee splits, place-of-service coding, and multiple procedure rules.

Ambulatory Surgery Center-Based GI Groups

GI groups performing procedures in ASC settings who need a billing team experienced with facility and professional fee splits, place-of-service coding, and multiple procedure rules.

Hepatology and Advanced Endoscopy Practices

Specialized practices performing ERCPs, EUS, and complex hepatology procedures who need careful coding for high-dollar claims and consistent prior authorization tracking.

Hepatology and Advanced Endoscopy Practices

Specialized practices performing ERCPs, EUS, and complex hepatology procedures who need careful coding for high-dollar claims and consistent prior authorization tracking.

Hospital-Based and Multi-Specialty GI Departments

GI departments operating within hospitals or multi-specialty groups who need accurate billing, place-of-service compliance, and consistent reimbursement tracking across mixed payer types.

Hospital-Based and Multi-Specialty GI Departments

GI departments operating within hospitals or multi-specialty groups who need accurate billing, place-of-service compliance, and consistent reimbursement tracking across mixed payer types.

Gastroenterology Billing Expertise Vs General Billing Services

Endoscopic procedures, pathology coordination, and coding specificity make gastroenterology billing particularly demanding. The breakdown below highlights common obstacles and our approach to addressing them.

General Billing Service

Generic multi-specialty with no GI-specific coding knowledge
CPT selection often inaccurate across GI procedures
Modifier 33, PT, 59, XU, and 51 misapplied or skipped
Incorrect conversion coding impacts patient trust
Pathology and biopsy add-on codes frequently missed
Prior authorization timelines frequently missed, delaying payment

Our Gastroenterology Billing Expertise

Dedicated focus on Medicare, Medicaid, and commercial GI billing
Applied correctly across GI procedures
Applied correctly on every applicable claim per payer rules
Converted accurately based on procedure findings and payer rules
Captured on every applicable claim to protect full reimbursement
Tracked actively for all PA-required procedures

Proven Results for Gastroenterology Billing Performance

Our gastroenterology billing team helps maximize reimbursement for endoscopic procedures, improve documentation compliance, and reduce avoidable denials.

98.4%

Endoscopy claims paid on first submission

95%

Procedure documentation compliance

< 20 Days

Average reimbursement turnaround

29%

Reduction in colonoscopy-related denials

What Our Clients Say About Us

Healthcare providers across the country rely on OneMed Billing to manage their revenue cycle with accuracy, consistency, and specialty-specific expertise. Here is what some of them have to say.

Testimonials

“We kept losing money on screening colonoscopies that turned diagnostic mid-procedure, and our previous biller never handled the conversions correctly. OneMed reviewed our coding workflow, fixed the modifier 33 and PT application, and our reimbursement on those claims stabilized within the second cycle. ”

Practice Owner, Independent Gastroenterology Practice

“Pathology add-on codes were quietly being missed on a large portion of our colonoscopy claims, and the revenue loss was significant. OneMed identified the gap, corrected the workflow, and our per-procedure reimbursement improved in a way we could actually measure. ”

Office Manager, Multi-Provider GI Group

“Prior authorization for ERCPs was a constant bottleneck and we were losing revenue every month. Since OneMed took over, PAs are tracked actively, claims go out clean, and our A/R has tightened in a way we can actually measure. ”

Director of Operations, Advanced Endoscopy Practice

Frequently Asked Questions

Do you bill for both Medicare and commercial gastroenterology claims?

Yes. We handle Medicare, Medicare Advantage, Medicaid, and commercial payer claims for gastroenterology practices across the US.

Can you work with our current practice management or GI-specific software?

Yes. We work with most major practice management and GI billing platforms and can integrate with your existing workflow without requiring a system change.

Will we still have visibility and control over our billing?

Absolutely. You receive regular reporting and have full access to your billing data at all times.

Do you handle CPT coding or just claim submission?

We review procedure notes and pathology reports to ensure accurate CPT coding, correct modifier usage, and proper supporting documentation before every claim goes out.

What happens if a claim is denied due to coding or documentation issues?

We identify the gap, coordinate with your clinical team to resolve it, and resubmit the claim with the corrected operative report, pathology findings, or modifier within our standard turnaround window.

Gastroenterology Billing Services

Gastroenterology Billing Structured Around Your Practice

Gastroenterology Billing Structured Around Your Practice

Cardiology Medical Billing Services

500+

Better Revenue. Better Care.

Clean Claims

Faster Payments

HIPAA Compliant

Gastroenterology Billing Requires Specialized Expertise

What Our Gastroenterology Billing Services Include

Insurance Verification

Endoscopy and Procedure Billing

Add-On Code and Polyp Removal Billing

Sedation and Anesthesia Coordination

Pathology Referral Billing

AR Recovery and Reporting

Our Gastroenterology Billing Process

Charges Received

Billing Review

Claim Submission

Payer Follow-Up

Denial Management

Payment and Reporting

Who We Serve?

Independent Gastroenterology Practices

Independent Gastroenterology Practices

Ambulatory Surgery Center-Based GI Groups

Ambulatory Surgery Center-Based GI Groups

Hepatology and Advanced Endoscopy Practices

Hepatology and Advanced Endoscopy Practices

Hospital-Based and Multi-Specialty GI Departments

Hospital-Based and Multi-Specialty GI Departments

Gastroenterology Billing Expertise Vs General Billing Services

General Billing Service

Our Gastroenterology Billing Expertise

Proven Results for Gastroenterology Billing Performance

What Our Clients Say About Us

Frequently Asked Questions

Do you bill for both Medicare and commercial gastroenterology claims?

Can you work with our current practice management or GI-specific software?

Will we still have visibility and control over our billing?

Do you handle CPT coding or just claim submission?

What happens if a claim is denied due to coding or documentation issues?

Request a Cardiology Billing Audit or Get a Claim Audit Review

Gastroenterology
Billing Services

Request a Cardiology Billing Audit
or Get a Claim Audit Review