Skip to main content

Could Your GI Practice use a Better Gastroenterology Billing and Practice Management Solution?




Nine signs it’s time to upgrade your technology and services


Are you spending too much time on billing- and office-related issues? Does your staff spend hours manually tracking metrics in spreadsheets? Does it take you more than 40 days to collect on an average balance?

If you answered yes to any of these questions, keep reading.

Amid declining reimbursements, complicated regulations and increasing patient responsibility, it can be harder and harder to keep the business side of your practice running smoothly. But the good news is, having the right combination of technology and services can help make it much easier.

Whether or not you currently use a practice management system or a gastroenterology medical billing service, here are nine signs your practice should consider switching to a better solution.

1. You have too little visibility into your financials

They say knowledge is power. Especially when it comes to your practice’s financials, it’s true.

For many gastroenterologists, getting a solid answer to the question “Is my practice financially healthy?” is much harder than it should be.

With all the time you spend seeing patients, it can be hard to really keep tabs on what’s happening in your billing department. And unfortunately, many in-house billers lack the experience and training to understand the bigger picture of practice performance.

Since billing staff often obtain their training from the billing supervisor before them, some billers never learn how to look at the entire process. They may not know which metrics are most important or how to track them, and they may not have time to spend on staying up to date with industry changes.

Especially for a small practice, it can be very difficult to recruit a knowledgeable biller who understands the whole revenue cycle. Plus, it can be hard to foster real transparency without effective processes and practice management technology.

In some cases, even with an outsourced gastroenterology billing service, it can be hard to get clear communication about your billing processes and overall practice health.

But with the right gastroenterology billing service combined with the right technology, it’s achievable. At any time, you can easily log into the gastroenterology practice management software system to see the status of each claim.

With modmed® gBOOST, your Client Manager will even send you a monthly financial health report and meet with you to go over it. You’ll know what’s going well, what could be improved and what steps to take to help achieve better results.

2. Scheduling takes way too long

When your patients call your practice to schedule an appointment, do they often hear your staff say “Sorry, hold on—this scheduling system is really slow?”

Scheduling software that’s sluggish to load or requires too many clicks could be creating bottlenecks and slowing down your entire practice. With check-in, checkout and other routine tasks that happen dozens of times per day, time spent on them all adds up fast, as do the frustrations slowness can cause for both staff and patients.

But with a high-quality gastroenterology practice management system that’s designed to match the way real practices operate, staff can use an automated appointment finder to book appointments faster. This template-based approach helps your staff take back some of those wasted minutes and hours, while also giving patients back more time with each phone call.

To help speed things up even more, you can connect an automated reminder system to your gastroenterology practice management system to send calls, emails or texts to patients before their appointments. That way, you can help decrease no-shows without your staff taking the time to call each patient individually.

In addition to powerful customization options, some reminder systems even allow you to send on-demand messaging. For instance, if you have to close your office because of a natural disaster—or if you’re simply running way behind schedule—you can easily keep your patients updated.

3. Your claims are getting rejected or denied too often

It’s normal for a certain amount of claims to be rejected or denied on first submission—up to around 5% for rejections and 10% for denials. But if your rates are higher than these benchmarks, it could signal some serious problems with your gastroenterology billing processes.

There are things you can do with your current resources and technology to try to reduce rejections and denials. But your staff only has so much time to spend managing claims, and there are more efficient options out there for helping improve claim accuracy.

With advanced technology, you can save a huge amount of time by automating key functions. For instance, a quality gastroenterology practice management software system can automatically verify insurance eligibility in real time prior to the appointment. This can help you identify issues to address before the patient even comes in.

It can also provide multiple levels of built-in claim scrubbing and let you create custom scrub rules, helping you catch and fix errors and coordination of benefits (COB) balancing issues before sending claims out. And if a claim does get denied, a gastroenterology practice management system with a powerful clearinghouse interface can show you why claims got rejected or denied, which can help you appeal or refile them.

The biggest timesaver of all? With a robust gastroenterology billing service, the vendor can actually help manage rejections and denials for you, so your staff may not have to spend any time on them.

Instead of claims falling through the cracks because your staff doesn’t have time to follow up on them, the gastroenterology medical billing company’s team can work with the clearinghouse or payer to help get them accepted.

4. Bridge issues are slowing you down

When you connect two software systems made by different vendors through a bridge, you can run into a variety of issues.

First of all, only certain types of data can transfer through the bridge. In the case of a gastroenterology practice management system and EHR system from different vendors, this means that they can’t work together quite as closely as if they were made by the same vendor.

Second of all, the cost of the bridge adds extra to the cost of both software systems, which can make it more expensive than an all-in-one solution.

And third, there are a wide variety of factors that can cause bridges to go down, such as one vendor updating their system without notifying the other vendor.

Even if it only happens occasionally, this can cause significant inconvenience for your practice. While the bridge is down, your staff may have to input data manually, slowing down important processes.

Plus, it can be difficult to catch all the data that might have been missed. This can potentially lead to charges being dropped from your gastroenterology practice management software.

Between the monetary costs and staff time spent on managing bridges, it can be much easier to have an all-in-one software solution for gastroenterology practice management and EHR.

5. You’re always behind on collections

How long from the date of service is it taking you to collect what you’re owed?

In a healthy practice, it shouldn’t take more than 35-40 days, and at least 85% of your revenue should be collected within 60 days.

But when your staff is always overloaded trying to keep up with all the claims you’re billing, it can sometimes start to feel like you’re running on a hamster wheel—like making forward progress is impossible.

That’s where the right gastroenterology medical billing service can help. By working with experienced specialists, you can help get caught up on collections and speed up your revenue cycle.

In addition to managing your billing and collections, a gastroenterology medical billing service can help you put better processes in place and implement efficient technology that automates some of the work.

6. You’re doing your financial and operational reporting manually

There was a time when spreadsheets were the fastest and most cutting-edge way to track gastroenterology practice performance. And—fortunately—that time is long gone.

Tracking metrics manually in spreadsheets is a slow, labor-intensive process. Plus, it’s hard to get the fast, up-to-date information that helps you make effective decisions when all the figures needed for each calculation must be collected and entered by hand.

That’s why top-quality gastroenterology practice management software lets you access comprehensive automated reports covering everything from claim management to patient accounts to month-end summaries. Without having to export anything, you can manipulate data and apply filters to help you understand the full picture.

When you use the right all-in-one technology and services solution, you can get even more insights. As mentioned under point #1, a good gastroenterology medical billing company can pair you with a Client Manager, who can send you comprehensive financial health reports each month and go over them with you.

All this helps you stay more up to date on your reporting while freeing up more of your staff’s time.

7. Biller turnover threatens your practice’s ability to function

Finding an experienced biller for your practice (and paying them enough to retain them) can be extremely difficult.

When your practice relies so much on one person, what would you do if they left?

Unfortunately, many practices find that their operations would virtually grind to a halt without their key biller.

But there’s one easy way to “futureproof” your practice against this situation: enlisting help from a gastroenterology medical billing service. A vendor has the economies of scale to help them recruit and retain top-notch, experienced revenue cycle management specialists. They can provide the continuity you need from your billing support, and you can take comfort in knowing you’re not dependent on any one person.

8. Your patients don’t have a clear understanding of their balances

Patient collections are a top challenge for today’s gastroenterology practices. But one factor contributes substantially to the ability to pay: understanding what and why they owe you.

If the patient thought a service would be covered by their insurance but they receive a bill for it several months after the procedure, they can be understandably confused and frustrated. And especially if they have a hard time getting a hold of your staff to ask about what’s going on, they may not feel particularly compelled to pay.

This is where the right gastroenterology medical billing services and practice management software come in.

Some gastroenterology practice management software platforms can actually estimate the patient’s out-of-pocket costs before the appointment based on their insurance information, so patients know what to expect. A good system can also display outstanding patient balances to check-in and checkout staff, so they can speak to the patient about the charges and make an effort to collect.

After the appointment, an all-in-one practice management and gastroenterology billing service can help patients understand their balances by notifying them through multiple channels, including detailed paper statements, patient portal messages and courtesy calls.

Some gastroenterology medical billing companies even offer inbound patient hotlines, so patients can get answers about their balances from trained customer service representatives without tying up your staff. To make payment more convenient for patients, they can also provide integrated online payment methods and options for payment plans.

9. Concerns about staying profitable are keeping you up at night

When you’re trying to manage the financial and operational sides of your practice on top of caring for patients, it’s a lot to deal with on your own. They didn’t teach you this stuff in medical school, after all.

But when you know that you have an experienced technology and services provider keeping things running smoothly and supporting you at every step, it’s not so overwhelming anymore. Instead of worrying about whether you’re collecting on your bills properly, you can feel more confident about your practice’s ability to achieve long-term success even in the face of industry challenges.

And having peace of mind—well, that’s what it’s all about.

1 Healthcare Business and Technology