Gastroenterology Medical Billing & Credentialing Services

End-to-End Revenue Optimization for GI Practices, ASC Facilities, and Specialists

Gastroenterology billing is a high-stakes, procedure-heavy specialty that demands precision in coding, modifier use, and compliance. With frequent use of endoscopic procedures, pathology, biopsies, sedation, and ambulatory surgical center (ASC) billing, GI practices face a wide range of complex billing scenarios—each with its own payer-specific rules and audit triggers.

At Oakview Medical Billing Solutions, we bring deep domain expertise in GI-specific coding, compliance documentation, and payer credentialing. From solo practitioners to large endoscopy centers, we handle the full spectrum of RCM services, ensuring optimal reimbursement, fast payment cycles, and compliance protection.

Gastroenterology Billing Challenges We Solve

Gastroenterology billing has some of the most complex combinations of procedure codes, modifier rules, and payer-specific requirements in all of medicine. Here's where Oakview delivers unmatched value:

Complex Endoscopy Bundling & Unbundling

Payers often bundle multiple procedures performed during a single session (e.g., EGD + biopsy + dilation). We ensure accurate modifier use (e.g., 59, 51, 26, 33) to capture full reimbursement when procedures are clinically justified as separate.

ASC vs. Office Billing

GI providers may perform services in both office settings and ASCs. We manage site-specific rules, facility fees, and place-of-service code accuracy to avoid underpayments.

Biopsy + Pathology Integration

We ensure both the GI and lab components of biopsies are billed correctly—preventing denials when codes like 88305, 88342, or 88312 are involved.

Anesthesia & Moderate Sedation

For procedures like colonoscopy or EGD, we handle separate billing for moderate sedation (99152–99153) or anesthesia claims submitted by an external provider.

Preauthorization for High-Cost Procedures

We handle pre-auths for procedures like video capsule endoscopy, ERCP, and esophageal manometry—ensuring prior approval to avoid retroactive denials.

Key Gastroenterology CPT Codes

Gastroenterology Credentialing & Contracting Services

Credentialing is the first step to successful reimbursement. Oakview handles the entire process—ensuring GI providers and facilities are approved and paneled with key payers.

We Credential:

Gastroenterologists (MD, DO)
GI Nurse Practitioners (NPs)
Physician Assistants (PAs)
Ambulatory Surgical Centers (ASCs)
GI Labs & Pathology services
Mobile GI Units (for underserved/rural clinics)

Credentialing Services Include:

CAQH Registration & Updates
NPI (Type 1 & Type 2) Setup
Medicare & Medicaid Enrollment
Commercial Payer Contracting (UHC, BCBS, Aetna, Cigna, Humana)
Managed Medicaid & Medicare Advantage Plans
Facility credentialing for ASCs and GI suites
EHR/EMR integration and clearinghouse setup

Oakview Supports These Practice Types

Private GI practices (solo or multi-provider)
GI hospitalists and consultants
Mobile endoscopy units
Office-based endoscopy providers
Multi-specialty groups with GI department
Ambulatory Surgical Centers
Academic or teaching hospitals

Our Comprehensive RCM Services Include:

✔ Real-time Insurance Verification
✔ Prior Authorization Management
✔ Charge Entry & Claim Scrubbing
✔ GI-specific Coding (CPC-certified coders)
✔ Claim Submission & Clearinghouse Integration
✔ Denial Management & Appeals
✔ Patient Statement & Collection Integration
✔ Monthly KPI Reporting (collections, aging, denial rates)
✔ Credentialing Dashboard Access
✔ ASC & pathology billing under one roof

Why Gastroenterologists Choose Oakview

Deep understanding of GI-specific billing rules
Proven success with both simple and complex procedures
Faster reimbursements and lower denial rates
Dedicated GI account managers & coders
No volume minimums—ideal for solo & group practices
100% U.S.-based, HIPAA-compliant team

Get Started with Oakview

Whether you're launching a new GI practice, expanding into ASCs, or tired of billing delays and denials—Oakview is your strategic partner for high-performing gastroenterology revenue cycle management.