AI-Powered RCM Built for Gastroenterology Practices
From screening-versus-diagnostic colonoscopy logic and ASC facility billing to modifier accuracy and denial management — SCALE delivers revenue cycle intelligence purpose-built for GI groups, ASCs, and MSOs.
Endoscopy & Colonoscopy Coding
Screening vs. diagnostic logic & PT/33 modifiers
ASC Facility Billing
Facility + professional split for in-suite procedures
Anesthesia Coordination
MAC billing alongside endoscopy claims
Prior Authorization
Advanced endoscopy & biologics for IBD
Real-Time RCM Analytics
Live dashboards via SCALE's analytics platform
Gastroenterology billing is uniquely complex. We know it cold.
High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
Screening-vs-Diagnostic Confusion
Colonoscopy claims hinge on screening/diagnostic status and modifiers (PT, 33) that, when wrong, shift cost to patients and trigger denials.
ASC & Professional Split Billing
In-suite procedures require coordinated facility and professional claims that frequently fall out of sync.
IBD & Biologic Authorization
Infusion and biologic therapies for IBD carry heavy prior-authorization and buy-and-bill requirements.
How SCALE solves it
GI Prior Authorization
We manage advanced-endoscopy and IBD-biologic authorizations end to end — including appeals.
GI Coding & Charge Capture
Automated review flags screening/diagnostic logic, modifier, and bundling errors across endoscopy claims.
Gastroenterology Denial Management
Payer-specific appeal templates for screening, modifier, and medical-necessity denials.
ASC & Anesthesia Revenue Integrity
Coordinated facility, professional, and MAC capture for in-suite procedures.
End-to-end RCM for every Gastroenterology encounter
Automation handles volume and velocity. Our experts handle exceptions, edge cases, and strategic optimization — creating a closed-loop system that continuously improves performance over time.
Discovery & Audit
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
EHR Integration
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
Go-Live & Handoff
SCALE's dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Continuous Optimization
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE clients
Representative results across SCALE Healthcare clients. Individual outcomes vary by organization size, payer mix, and baseline RCM maturity.
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
Works inside the EHRs your team already uses
Let’s build your Gastroenterology RCM roadmap together
Book a free 30-minute strategy call with a SCALE Gastroenterology specialist. We’ll review your current denial rates, authorization backlog, and coding performance — at no cost.