For Gastroenterology Practices
Eligibility Verification for Gastroenterology Practices
EligibilityMD automates insurance eligibility verification for gastroenterology practices — including the screening-vs-diagnostic colonoscopy classification that's behind most GI patient billing complaints.
The problem
GI is uniquely exposed to coverage misclassification. A screening colonoscopy that turns diagnostic mid-procedure changes the patient's financial responsibility in ways the front desk had no way to predict, and prior auth requirements vary wildly by payer and CPT. Manual verification can't keep up with your endoscopy schedule.
What EligibilityMD does
We verify coverage, benefit category, deductible status, and procedure-level prior auth on every scheduled visit and procedure 1–3 days early. Screening vs diagnostic logic, MAC region rules, and payer-specific auth requirements are pre-checked. Your team only touches the exceptions.
What changes for your practice
- +75% reduction in eligibility verification time
- +Coverage issues caught 1–3 days before the visit
- +Eligibility-based denial rate below 10% within 60 days
- +Your front desk focuses on patients, not payer portals
Backed by our 90-day guarantee. If we don't hit the benchmarks we put in writing, you get your money back.
See also