Nexus io helps GI practices improve their finances and reduce administrative workload with proven results. Our gastroenterology revenue cycle management combines AI-powered technology and specialized GI procedure coding expertise to achieve 98% clean claims rates and reduce accounts receivable by 30%.
Gastroenterology medical billing encompasses the complete claims submission process. This eliminates the administrative complexity while speeding up the reimbursement cycles for GI practices. Nexus io’s gastroenterology medical billing and coding services use AAPC-certified coders with specialized GI expertise. We accurately map each endoscopic procedure, interventional technique, and follow-up service to the corresponding CPT, ICD-11, and HCPCS codes, HIPAA guidelines.
This precision directly contributes to increased reimbursements and claims acceptance rates. Our coding team stays updated with current knowledge of annual CPT updates, CMS LCD requirements, and payer-specific billing guidelines across all 50 states we serve.
Gastroenterology billing creates significant administrative overhead. Nexus io’s gastroenterology revenue cycle management solution addresses every revenue touchpoint through specialized protocols.
Outsourcing gastroenterology billing services to Nexus io allows gastroenterologists to reclaim time that can be spent more on patient care. Our claim scrubbing technology contributes to a 98% first pass claim ratio. Further, aggressive denial management and accounts receivable follow-up achieve a 30% reduction in outstanding balances.
Collection Ratio
Revenue Growth
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First Pass Claim Ratio
Gastroenterology billing breaks down in predictable places. Authorization delays create scheduling gaps and revenue losses. Staffing overload prevents timely claim submission. Minor coding errors compound into major cash flow disruptions.
The financial impact of these challenges is quantifiable. On average, practices lose between 3%-5% of their potential income due to billing errors that can easily be fixed.
To maintain steady cash flow and stay compliant, gastroenterology practices must address the three central challenges that have been identified:
Clean Claims Rate
Reduction in A/R
Coding Accuracy Rate
Gastroenterology claims face higher denial rates than most specialties. According to the Medical Group Management Association (MGMA), gastroenterology’s average denial rate is 6.7%—significantly higher than the 4.9% median denial rate across all specialties.
Nexus io minimizes this risk through specialized GI billing expertise. Our AAPC-certified medical coders review documentation, assign precise CPT codes, apply necessary modifiers, and run every claim through multi-layer scrubbing before submission.
Most billing errors stem from missing referral letters or incomplete eligibility checks. These mistakes trigger compliance issues with Medicare’s local coverage determinations (LCDs) and commercial payer policies for endoscopy procedures.
Heavy workloads cause rushed coding. Staff overlook critical details such as incorrect ICD-11 or HCPCS code selection, missing or wrong modifiers, delayed pre-authorizations, and incomplete documentation that expose practices to audit risk.
Gastroenterology medical billing services from Nexus io help reduce these errors through accurate coding, proper documentation, and timely submissions, minimizing compliance risks.
We address these challenges systematically:
Gastroenterology coding requires specialized knowledge. Nexus io streamlines the process so you get paid accurately for every service:
All coding staff assigned to your account hold AAPC certification and specialize in GI procedures. Our RCM solution ensures billing that’s efficient, compliant, and accurate.
Nexus io provides round-the-clock support for your gastroenterology medical billing services. Our team manages pre-authorizations, handles denial resolution immediately, and addresses complex billing scenarios involving conscious sedation and biopsy bundling.
Each claim adheres to payer-specific rules across commercial insurers and Medicare. We track regulatory differences in all 50 states we serve. Our gastroenterology RCM solution removes administrative burden from your staff, allowing physicians to concentrate on patient care while we manage revenue cycle operations.
Operational costs drain resources from GI practices while billing complexities slow down revenue. Nexus io’s gastroenterology billing services cut expenses and improve efficiency through proven processes that deliver measurable financial results.
Our affordable and custom-made solutions eliminate the need for in-house billing infrastructure, ongoing staff training, and compliance management overhead.
GI Supply Billing Management: We code infusion pumps, enteral nutrition supplies, and ostomy products accurately so you get paid promptly.
Start improving revenue outcomes with a partner experienced in gastroenterology billing and coding. We help GI practices navigate complex requirements, maintain compliance, and reduce administrative strain.
To explore how our solutions can support your practice, submit a brief inquiry. One of our gastroenterology billing specialists will respond within 12 hours.
What makes gastroenterology billing different from general medical billing?
Gastroenterology billing is different from general medical billing because it includes specialty coding for more complex procedures such as colonoscopy, ERCP, EGD and polypectomy. Gastroenterology billing has many more complications associated with modifier rules, multiple procedure reductions, and documentation standards than general medical billing and requires specialized knowledge of gastroenterology billing and coding.
How does Nexus io minimize claim denials for GI practices?
By using AI-powered claim scrubbing technology along with a team of specialty-trained gastroenterology billers, Nexus io is able to identify mistakes that lead to claim denials, including incomplete or inaccurate modifiers, before they are sent to payers. As a result, Nexus io has greatly reduced the number of denied claims and has improved revenue cycle management.
Can Nexus io integrate with my current gastroenterology EHR system?
Yes! We provide a seamless integration between major gastroenterology EHRs and allow for easy data transfer, allowing your billing workflow and revenue cycle to run much more quickly.
How does Nexus io maintain compliance with GI-specific payer regulations?
Nexus io has a compliance department that keeps track of Medicare LCDs, NCCI edits and other payer policies that pertain to gastroenterology billing. Every claim is reviewed and matched with documentation requirements to protect your practice from denied claims and possible audits.
What type of reporting can I receive from Nexus io for my gastroenterology practice?
Nexus io provides you with real-time dashboards so you can see the volume of procedures billed, collections processed, claim status and payer performance on a continuous basis, allowing you to manage the complete revenue cycle for your GI practice.
How does outsourcing gastroenterology billing services to Nexus io save money?
By outsourcing your gastroenterology billing to Nexus io, you will experience fewer claim denials, faster and more efficient revenue cycle management and increased cash flow to your practice.
Optimizing reimbursement in gastroenterology requires accurate coding, compliance with complex payer guidelines, and timely claim submissions. Our expert team ensures every claim is processed with precision and compliance, so your practice can focus on patient care while we handle billing complexities.
Complete the short form, and one of our specialists will connect with you within 12 hours to discuss your specific gastroenterology billing needs.
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