Take the Stress Out of Gastroenterology Billing
Let MedCloudMD Handle It You didn't spend years mastering gastroenterology to spend your evenings untangling claim denials and chasing down prior authorizations. At MedCloudMD, we specialize in GI billing and revenue cycle management that works so your practice gets paid accurately, on time, every time.
Get Started
.png)
Average Days in AR
Our Performance Metrics That Drive Your Success
< 30
Collection Ratios
97%
Revenue Improvement
12–18%
99%
First Pass Ratio
Clean Claims Accuracy
98%
Gastroenterology Practices Trust MedCLOUDMD
GI billing is genuinely complicated. Between colonoscopy screening versus diagnostic coding rules, add-on procedure billing for polyp removals, prior authorizations for biologics and infusion therapies, and the ever-changing payer policies around endoscopic procedures there's a lot that can go wrong. Add state-specific Medicaid GI coverage policies and bundling rules that vary by payer, and payments can slow to a crawl.
MedCLOUDMD takes all of that off your plate. We handle the billing complexity so your gastroenterologists and clinical staff can stay focused on patient care — not paperwork. With your revenue cycle running smoothly, your practice keeps moving forward.
Gastroenterology billing rules change constantly from colonoscopy screening code updates to evolving infusion therapy reimbursement policies and new endoscopic procedure coverage criteria. MedCLOUDMD tracks every change across Medicare, Medicaid, and commercial payers so your claims always reflect current requirements and nothing slips through the cracks.
Always Current on GI Billing Rules
Prior Authorizations Handled Start to Finish
Biologics for Crohn's disease and ulcerative colitis, infusion therapies, capsule endoscopy, and advanced endoscopic procedures often require prior authorizations that are time-consuming and frustrating to manage. We handle the entire process submitting requests with complete clinical documentation, tracking approval timelines, communicating directly with payers, and securing renewals before they expire. Your patients get uninterrupted care. Your practice gets paid.
Documentation That Protects Your Revenue
Endoscopy reports, infusion records, pathology documentation, prior authorization records every detail matters in GI billing. MedCLOUDMD reviews your clinical documentation proactively, identifying gaps before they turn into denials or audit triggers. We help your practice stay both reimbursed and protected.
Deep Medicare and Commercial Payer Knowledge
Medicare's rules for screening versus diagnostic colonoscopy are among the most misunderstood in all of GI billing and getting them wrong costs practices thousands. Commercial payers add their own layers of complexity with different coverage policies for capsule endoscopy, infusion therapies, and advanced endoscopic procedures. We know the rules for every payer you work with and apply them precisely on every claim.
Denials Addressed Fast
And Prevented First When a GI claim is denied, we don't wait around. We investigate the reason, correct the issue, and file the appeal quickly. More importantly, we study denial patterns and fix root causes so the same problem doesn't keep recurring. Your accounts receivable stays clean and your cash flow stays healthy.
You should always know exactly where your money stands. MedCLOUDMD gives you clear, real-time dashboards showing claim status, payment timelines, procedure-specific reimbursement rates, and outstanding AR so you can make confident decisions about your practice's financial health every single day.
Real-Time Visibility Into Your Revenue
Benefits to Hire MedCloud MD
Common Challenges in Gastroenterology Billing And How MedCLOUDMD Solves Them
Even experienced in-house billing teams struggle with the unique complexity of GI billing. The rules are specific, the stakes are high, and errors compound quickly across high-volume endoscopy practices. Here's what trips up most GI practices and how we fix it:
This is one of the most financially significant coding challenges in all of gastroenterology. When a screening colonoscopy becomes diagnostic during the procedure because a polyp is found and removed the billing rules change, and so does the patient's cost-sharing responsibility. Getting this wrong leads to claim denials, patient billing disputes, and compliance risk. Our certified GI billing specialists navigate these distinctions precisely, ensuring every colonoscopy claim reflects the correct intent and outcome with the right codes and modifiers.
2. Add-On Procedure and Bundling Complexity
GI procedures frequently involve multiple interventions during a single endoscopy session biopsy, polyp removal, dilation, ablation each with their own CPT codes and bundling rules. NCCI edits and payer-specific bundling policies determine what can be billed separately and what must be bundled. Getting this wrong means either lost revenue from underbilling or audit risk from inappropriate unbundling. We apply the correct coding and modifier combinations on every procedure, capturing everything you're legitimately owed.
3.Infusion Therapy and Biologic Prior Authorizations
Biologics for inflammatory bowel disease including Humira, Remicade, Stelara, and Entyvio require prior authorizations that are notoriously complex and time-consuming. Step therapy requirements, clinical documentation standards, and renewal timelines vary significantly across payers. Failing to navigate these correctly results in denied infusion claims and interrupted patient treatment. We manage the entire authorization lifecycle, ensuring your IBD patients receive uninterrupted biologic therapy while your practice gets paid.
4. Frequent Claim Denials and Rework
GI claims face higher-than-average denial rates due to complex coding requirements, screening versus diagnostic disputes, and strict medical necessity criteria for advanced procedures. Payers scrutinize endoscopy claims carefully and often reject claims for modifier errors, bundling issues, or insufficient documentation. Our pre-submission claim validation process catches these issues before claims go out, dramatically reducing denials and the administrative burden of rework.
5. Capsule Endoscopy and Advanced Procedure
Coverage Capsule endoscopy, endoscopic ultrasound, ERCP, and Barrett's esophagus ablation procedures have strict and evolving coverage criteria. Each payer has different prior authorization requirements, medical necessity documentation standards, and coverage policies. Billing these procedures without payer-specific expertise leads to denials and delayed reimbursement on some of your highest-value services. We navigate every payer's requirements for advanced GI procedures to maximize your reimbursement.
Why Choose MedCLOUDMD for Gastroenterology Billing Services?
GI billing is too complex and too specialized for a generalist billing company. You need a partner who understands colonoscopy coding rules, infusion therapy authorizations, NCCI bundling edits, and advanced endoscopic procedure billing inside and out. That's exactly what MedCLOUDMD delivers. Our certified GI billing specialists file first-pass clean claims, reducing denial rates by 5% to 10% and protecting every dollar your practice has earned.
GI Billing Is All We Think About
Our team works inside gastroenterology billing every day dealing with the same screening versus diagnostic disputes, biologic authorization challenges, and bundling complexities your practice faces. Because we know where things break down, we catch problems early before they cost your practice money.
Your Patient Data Is Always Protected HIPAA compliance is non-negotiable at MedCLOUDMD. We maintain strict data security protocols encrypted transmission, secure servers, limited access controls, and regular compliance audits protecting every piece of patient and practice information we handle on your behalf.
Secure and Compliant Billing
Clean claims from the start means fewer delays, fewer denials, and faster payments. MedCLOUDMD focuses on getting every GI claim right the first time and follows up aggressively with payers when payments don't arrive on schedule.
Accurate Claims Mean Faster Revenue
We Recover Revenue You Didn't Know You Were Losing Underpayments on colonoscopy procedures, infusion therapy claims, and advanced endoscopic services happen more often than most practices realize. MedCLOUDMD identifies these discrepancies and pursues recovery — making sure every claim is paid at the correct contracted rate.
Denial Prevention and Revenue Recovery
.png)
.png)
.png)
.png)
.png)
.png)
.png)
.png)
Prevent Costly Gastroenterology Billing Errors with MedCLOUDMD
In GI billing, the details matter enormously. A single wrong modifier on a colonoscopy claim can trigger a denial. A missed prior authorization for an infusion can result in a completely unpaid biologic claim worth thousands of dollars. MedCLOUDMD puts systematic checks in place to catch these errors before they ever reach a payer.
What Often Goes Wrong
Screening vs. diagnostic colonoscopy coding errors
Bundling and unbundling errors on multi-procedure endoscopy
Missing biologic and infusion prior authorizations
Late claim filing
How MedCloudMD Helps
We apply the correct intent-based codes and modifiers based on procedure findings, preventing denials and patient billing disputes.
We stay current with NCCI edits and payer-specific bundling rules to capture all legitimate add-on procedures correctly.
We manage the full authorization lifecycle for all infusion therapies so treatment never gets interrupted and claims always get paid.
We submit all claims promptly within payer deadlines so your practice never loses payment eligibility due to timely filing limits.
Get In Touch with a Gastroenterology Billing Specialist
You shouldn't have to think about colonoscopy coding disputes, biologic authorization renewals, or infusion bundling rules at the end of a full day of procedures. That's exactly what MedCLOUDMD is here for.
We partner with gastroenterology practices like yours to handle every dimension of GI billing with the specialized knowledge and accountability it demands. When you work with our team, you get more than a billing service you get a partner who understands your specialty, anticipates payer obstacles before they slow your revenue, and works alongside you to bring real financial clarity to your practice.
Your patients need your full attention. Let us handle the billing.
Free Fee Schedule Auditing to Prevent Underpayments
Many gastroenterology practices are being quietly underpaid and most don't realize it. Contracted rates for colonoscopy procedures, infusion therapies, and advanced endoscopic services change with payer contract renewals, and underpayments can accumulate undetected for months.
MedCLOUDMD offers complimentary fee schedule audits specifically designed for GI practices. We compare your actual reimbursements against your contracted fee schedules across every payer, identifying discrepancies that are costing your practice money on your highest-volume and highest-value procedures.
Through this review, we help practices:
-
Uncover systematic underpayments on colonoscopy and endoscopy services
-
Verify biologic and infusion therapy reimbursements match contracted rates
-
Recover revenue on claims that were already paid at incorrect amounts
-
Build a more accurate reimbursement baseline that protects long-term revenue
This audit is completely free — because you deserve to know exactly what your practice is owed.
AI Powered Billing for Gastroenterology
Gastroenterology billing is complex. From colonoscopies and endoscopic procedures to pathology coordination and anesthesia billing, every detail matters. One small coding error can delay payment or trigger an audit. That is why at MedCloudMD we combine advanced AI technology with experienced billing specialists who understand the unique challenges of gastroenterology practices.
Our AI reviews claims in real time before they are submitted. It checks documentation, verifies modifiers, validates medical necessity, and flags missing information. It also compares payer rules and identifies patterns that could lead to denials. This allows us to catch errors early instead of reacting after revenue is already delayed.
But we do not rely on technology alone. Every flagged issue is reviewed by a trained gastroenterology billing expert. Our team verifies procedure codes, confirms diagnosis alignment, reviews endoscopy reports, and ensures compliance with payer specific guidelines. This human review layer protects your practice from overbilling, underbilling, and compliance risks.
AI helps us move faster. Our experts ensure we move correctly.
Together, this approach improves clean claim rates, reduces denials, shortens reimbursement timelines, and strengthens revenue predictability for your gastroenterology practice.
With MedCloudMD, you get intelligent automation backed by real people who understand your specialty and care about your financial health as much as you do.