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ASC Billing Experts

Ambulatory Surgery Center
Billing Support

Improve ASC revenue performance with accurate coding, clean claims, faster reimbursements, denial management, payer follow-up, and compliance-focused billing support designed for ambulatory surgery centers.

  • Clean Claims
  • Faster Payments
  • Denial Control
  • Coding Accuracy
98%
Clean Claim Rate
35%
Faster Reimbursements
25%
Fewer Denials
20%
Improved Collections
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Gastroenterology Billing Services for Practices That Are Tired of Scope Denials

A GI practice can lose the claim before the scope room is cleaned. One missed KX, a weak authorization note, or a lazy 45385/45380 modifier review can turn a clean colonoscopy claim into 45 days of payer ping-pong. Advanced IT and Healthcare Solutions handles gastroenterology billing services for practices that need tighter charge capture, cleaner claims, faster payer follow-up, and denial work that doesn't wait until Friday afternoon.

Gastroenterology billing services manage coding, charge entry, eligibility checks, claim submission, ERA posting, denial work, AR follow-up, patient billing, and reporting for GI practices. The work needs GI-specific checks for colonoscopy, EGD, biopsy, snare polypectomy, anesthesia, capsule endoscopy, motility testing, and payer-specific authorization rules.

Why GI Billing Breaks Faster Than General Medical Billing

General billing teams miss the small GI details because the claim looks normal until the payer reads it. A screening colonoscopy that turns diagnostic isn't the same claim. Anesthesia 00812 isn't the same as 00811 with PT. A positive FIT follow-up has its own Medicare handling. An EGD with biopsy can need a different review than a straight diagnostic EGD.

We see this in the queue: CO-16 for missing claim data, CO-97 when the payer bundles a service into another procedure, and CO-197 when the authorization trail isn't attached or doesn't match the CPT, date, units, or site. X12 lists CO-16 as a claim or service with missing information or a submission error, CO-97 as a service included in another service already paid, and CO-197 as absent precertification, authorization, notification, or pre-treatment.

A biller opens the ERA, sees 18 GI denials from UHC, Aetna, and BCBS, and knows the claim scrubber didn't catch the real problem: the payer needed a procedure-specific auth note, not a generic referral line. Outsourcing won't fix sloppy front-desk data. It can, though, give the practice a second control point before money goes stale in AR.

Clinical provider working

What Advanced IT and Healthcare Solutions Handles

Advanced IT and Healthcare Solutions handles eligibility, GI coding review, charge entry, claim scrubbing, submission, payment posting, denial work, AR follow-up, patient statements, and monthly KPI reporting. The service is built around clean claim rate, first-pass resolution rate, denial rate, days in AR, net collection rate, and cost-to-collect. Our team works the parts that usually sit between the front desk, coder, biller, and physician. That includes:

Eligibility and benefits checks before the visit, with payer notes for UHC, Aetna, Cigna, Humana, Medicare, Medicaid, and BCBS plans.
Authorization tracking for capsule endoscopy, ERCP, EUS, motility testing, biologic infusion add-ons, and advanced endoscopy cases.
Charge entry review within 24 to 48 business hours after documentation is signed.
Claim scrubbing for GI CPT, ICD-10-CM, HCPCS, modifiers, place of service, NPI, taxonomy, and payer edits.
ERA posting and denial coding by root cause, not by whatever note the payer dropped in the remittance.
AR follow-up by aging bucket: 0-30, 31-60, 61-90, 91-120, and 120+.

We don't promise magic. If the physician documents "colonoscopy done" and leaves out biopsy method, lesion removal method, or screening-to-diagnostic context, no billing vendor can safely invent the missing story. We send it back with the exact documentation gap.

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GI Codes and Edits We Watch Before Submission

GI claims need code-level attention. Practolytics lists CPT 43235 and 45378 as common GI billing codes on its page, but a real claim queue gets messier fast. Advanced IT and Healthcare Solutions reviews EGD, colonoscopy, sigmoidoscopy, small bowel capsule, motility testing, liver-related testing, and anesthesia line items against payer rules and available documentation. Common GI billing checks include:

45378 for diagnostic colonoscopy without specimen collection beyond brushing or washing.
45380 for colonoscopy with biopsy.
45385 for colonoscopy with removal by snare technique.
43235 for diagnostic upper GI endoscopy.
43239 for EGD with biopsy.
G0105 and G0121 for Medicare screening colonoscopy claims.
00812 for anesthesia tied to screening colonoscopy and 00811 when the screening becomes diagnostic with PT.
91110 for capsule endoscopy, 91010 for esophageal motility, 91065 for breath hydrogen or methane testing, and 91200 for liver elastography.

CMS CR 14031, issued in 2025, added payment for CT colonography CPT 74263 as a Medicare colorectal cancer screening service effective January 1, 2025, and ended coverage for barium enema screening codes G0106 and G0120. ASGE also warned in 2026 that Medicare needs modifier KX on the screening G code when colonoscopy follows a positive non-invasive stool-based test.

Reporting That a Practice Manager Can Use on Monday Morning

Many billing reports look busy and say almost nothing. We build reporting around metrics a practice manager, billing director, or physician owner can act on.HFMA MAP Keys place revenue cycle KPIs into patient access, pre-billing, claims, account resolution, and financial management groups. MGMA reported in 2026 that medical group leaders named denials and appeals as the largest revenue cycle leak at 48%, followed by front-end issues at 23%. That matches what we see when the front desk skips payer-specific benefit notes and the biller inherits the mess 28 days later. The monthly dashboard should show:

Clean claim rate.
First-pass resolution rate.
Denial rate by payer and reason.
Days in AR.
AR over 90 days.
Net collection rate.
Cost-to-collect.
Charge entry lag.
Payment posting lag.
Technology EHR and Documentation Workflow

EHR and Practice Management Systems

Advanced IT and Healthcare Solutions can work in common systems such as eClinicalWorks, athenahealth, AdvancedMD, Tebra/Kareo, NextGen, Greenway Intergy, Office Ally, DrChrono, and Epic-connected billing environments. The work usually starts with access review, workflow mapping, payer list cleanup, report pulls, claim status rules, and ERA posting controls. We don't need you to rip out your system. That would be expensive and usually pointless.

What we do need is clean access, clear task ownership, payer portal access, and permission to build a denial work queue that your team actually uses. If the practice has three people editing the same claim notes without a rule for who owns follow-up, the EHR isn't the problem. The handoff is.

Payer Workflows

Security and Compliance Language Buyers Won't Laugh At

We don't write "100% HIPAA compliant" because serious buyers know that's sloppy. Advanced IT and Healthcare Solutions uses HIPAA-aligned workflows, limited-access PHI handling, encrypted file transfer where available, user-level access controls, audit-ready documentation, and role-based work queues.

Security still needs buyer review. If your contract requires SOC 2 Type II, HITRUST, a BAA, data residency terms, or payer portal access rules, that has to be checked in procurement and legal review before go-live. Billing vendors shouldn't hand-wave that. PHI isn't a sales prop.

Technology EHR and Documentation Workflow

Onboarding Timeline

  • Week 1: access, payer list, EHR review, clearinghouse setup, user roles, sample claims, and reporting baseline.
  • Week 2: charge entry rules, denial category map, payer portal access, eligibility notes, and first claim audit.
  • Weeks 3-4: live claim handling, payment posting, AR work queues, denial appeals, and first KPI report.
  • Days 45-60: trend review, payer-specific fixes, provider documentation feedback, old AR cleanup plan, and decision on whether credentialing or prior auth support should be added.

Most practices don't need a six-month setup. They need two weeks of clean data review and another four weeks of blunt follow-up. If old AR is already over 120 days, though, recovery won't be quick. Some of it may be gone.

Payer Workflows

Pricing Model

Advanced IT and Healthcare Solutions can price GI billing work by percentage of collections, flat monthly fee, per-claim fee, or a mixed model depending on volume, specialty mix, old AR, payer spread, and scope. A five-provider GI clinic with in-office endoscopy doesn't carry the same work as a startup practice with one physician and clean commercial contracts. Buyers should ask three pricing questions before signing:

  • Is old AR included, capped, or quoted as a separate project?
  • Are authorization, credentialing, and patient statements included?
  • What happens if claim volume drops for 60 days?

Have any questions?

GI billing has procedure-specific rules for colonoscopy, EGD, biopsy, polypectomy, anesthesia, screening status, diagnostic findings, and payer authorization. A general biller may submit the claim, but GI denials often come from details that only show up after reviewing the scope note, modifier use, and payer policy.

Yes, but old AR should be scoped separately. AR over 120 days needs payer-by-payer triage, timely filing review, appeal limit review, and write-off risk tagging. Some claims can be recovered. Some can't. We won't pretend otherwise.

It can be included if the scope calls for it. GI practices often need auth tracking for capsule endoscopy, EUS, ERCP, motility testing, and payer-specific advanced procedures. Prior auth support has to be tied to scheduling so the claim isn't broken before the procedure happens.

We need EHR access, clearinghouse access, payer portal access, provider NPIs, taxonomy, fee schedule files if available, payer list, current AR aging, denial reports, sample charts, billing policy notes, and a named contact who can get answers from the physician within 24 to 48 business hours.

Usually, yes. We can work in systems such as eClinicalWorks, athenahealth, AdvancedMD, Tebra/Kareo, NextGen, Greenway Intergy, Office Ally, DrChrono, and Epic-connected environments. The first step is access review and a sample claim audit, not a software replacement pitch.

Clean claim and denial trend changes can show within 30 to 60 days if documentation and front-end intake are usable. Net collection and days in AR usually need 60 to 120 days because payer cycles, appeal limits, and old balances don't move in one reporting month.

A fair first term is usually 90 to 180 days with clear exit terms, data return rules, access shutdown rules, and KPI reporting. Avoid any agreement that hides old AR fees, patient statement costs, or payer enrollment work in vague language.