Specialties We Support

We provide expert solutions for all gastroenterology professionals, including:

✅Gastroenterologists (MD/DO) – Specialists in digestive system disorders, endoscopic procedures, and hepatology.
✅Hepatologists – Experts in liver diseases, including hepatitis, cirrhosis, and liver transplantation support.
✅Colorectal Surgeons – Surgeons specializing in diseases of the colon, rectum, and anus.
✅Gastroenterology Nurse Practitioners (NPs) – Advanced practice providers assisting in diagnosis, patient care, and procedural support.
✅Physician Assistants (PAs) in Gastroenterology – Healthcare professionals managing gastroenterology patient care under physician supervision.

All-in-One Gastroenterology Services

1. Credentialing & Payer Enrollment

Gastroenterology providers must be properly credentialed to bill insurance companies for endoscopic and digestive health procedures. We simplify the process to prevent delays and ensure smooth reimbursement.

✅Medicare, Medicaid & Commercial Insurance Credentialing
✅CAQH Profile Setup & Maintenance
✅EDI, ERA, and EFT Enrollment for Electronic Transactions
✅Re-Credentialing & Contract Renewals

2. Medical Billing & Coding for Gastroenterology

Billing for gastrointestinal services requires precise coding for procedures like endoscopies, colonoscopies, biopsies, and motility studies. Our expert billing team ensures maximum reimbursement with minimal claim denials.

✅CPT & ICD-10 Coding for Gastroenterology Procedures
✅Claims Submission, Reconciliation & Denial Management
✅Pre-Authorization & Eligibility Verification for GI procedures
✅Out-of-Network Billing & Patient Payment Support

3. EHR/EMR Setup & Integration

Gastroenterology practices require customized EHR/EMR systems to document procedures, patient history, and follow-up care efficiently. We assist in choosing, implementing, and optimizing the right system.

✅Gastroenterology-Specific EHR Setup & Optimization
✅Endoscopy & Procedure Documentation Integration
✅HIPAA-Compliant Data Management & Security
✅Telehealth Integration for GI Consultations & Follow-Ups

4. Compliance & Regulatory Support

With strict insurance policies and regulatory guidelines, gastroenterologists must follow HIPAA, Medicare, and commercial payer rules to avoid compliance risks and claim denials.

✅Medicare, Medicaid, and Commercial Insurance Compliance
✅MIPS & MACRA Reporting for Value-Based Reimbursement
✅Audit Readiness & Risk Management for GI Practices
✅State-Specific Licensing & Credentialing Compliance

5. Revenue Cycle Management & Practice Growth

Effective revenue cycle management (RCM) ensures timely payments and minimizes revenue leakage in gastroenterology practices. Our team provides end-to-end RCM solutions to optimize your financial health.

✅Financial Performance Monitoring & Revenue Analytics
✅Payer Contract Negotiation & Fee Schedule Optimization
✅Practice Expansion Consulting & Strategic Growth Support
✅Marketing & Referral Network Optimization for GI Providers

Types of Gastroenterology Services Billed

✅Upper GI Endoscopy (EGD) (CPT 43235-43259)
✅Colonoscopy (CPT 45378-45385)
✅Capsule Endoscopy (CPT 91110, 91111)
✅Liver Biopsy (CPT 47000, 47001)
✅Esophageal Motility Testing (CPT 91010, 91037)
✅pH Monitoring & Gastric Analysis (CPT 91034, 91035)
✅Hemorrhoid Ligation & Treatment (CPT 46221, 46255, 46260)
✅Endoscopic Ultrasound (EUS) (CPT 43237, 43238, 43253, 43259)
✅H. Pylori Breath Test & Stool Test (CPT 83013, 83014, 87338, 87339)
✅ERCP (Endoscopic Retrograde Cholangiopancreatography) (CPT 43260-43273)

Required Knowledge for Successful Gastroenterology Billing

1. Mastery of Gastroenterology-Specific CPT & ICD-10 Codes

Accurate coding is crucial to avoid claim denials and downcoding by payers. Understanding diagnostic vs. therapeutic procedures ensures proper reimbursement.

2. Pre-Authorization & Medical Necessity Compliance

Many gastroenterology procedures require pre-authorization, especially advanced imaging, endoscopic procedures, and surgical interventions. Knowing how to submit pre-approval requests efficiently reduces claim rejections.

3. Medicare & Medicaid Reimbursement Guidelines

Medicare and Medicaid have specific policies for routine and diagnostic endoscopic services. Understanding global periods, frequency limitations, and modifiers helps ensure full payment.

4. Insurance Credentialing & Payer Contracting Expertise

Getting in-network with commercial insurance plans and negotiating fair reimbursement rates ensures that gastroenterologists are paid appropriately for their services.

5. Telehealth & Virtual GI Care Billing

With the rise of virtual consultations, gastroenterologists need to understand how to bill telehealth visits, remote patient monitoring, and follow-up care under new payer policies.

Why Choose Solubillix for Gastroenterology Practice Management?

✔ Expert Credentialing & Billing Services to ensure faster approvals and payments.
✔ Gastroenterology-Specific EHR & Compliance Support for accurate documentation.
✔ Seamless Insurance Enrollment & Contract Negotiations to improve payer relationships.
✔ Specialized Gastroenterology Revenue Cycle Management to maximize reimbursements.
✔ End-to-End Practice Solutions including billing, compliance, and growth strategies.
✔ Dedicated Support for Gastroenterology Providers with customized solutions tailored to individual practice needs.

Get Started with Solubillix Today!

Let us handle the complexities of billing, credentialing, compliance, and revenue cycle management, so you can focus on providing exceptional patient care. Contact us today to see how we can support your gastroenterology practice!