Does the calculator estimate anesthesia concurrency factors?

Yes. Our engine monitors anesthesia concurrency guidelines, checking rules regarding overlapping procedures.

Are biological therapies for colitis supported?

Absolutely. We feature dedicated modules for biological colitis drug waste (JW/JZ) and prior-auth limit alerts.

How does the system handle colonoscopy screening-to-diagnostic transitions and the -PT modifier?

When a screening colonoscopy converts to diagnostic due to polypectomy or biopsy findings, our system automatically transitions the claim from CPT 45378 to the appropriate therapeutic code (e.g., 45385 for snare polypectomy), appending modifier -PT or -33 based on payer guidelines to prevent unexpected patient cost-sharing charges.

What support exists for ERCP and complex endoscopy billing?

We maintain dedicated ERCP coding rules covering sphincterotomy, stone extraction, stent placement, and brush cytology add-on codes, automatically verifying the correct procedure hierarchy and preventing NCCI edit denials on multi-technique ERCP claims.

How are capsule endoscopy technical and professional components split?

Our system generates separate technical component claims for capsule placement and device reading time, and professional component claims for the interpreting gastroenterologist, with correct modifier -26 and -TC assignments per payer billing requirements.

Does the platform support billing for chronic care management in GI practices?

Yes. We support CCM billing for patients with chronic GI conditions including Crohn's disease, ulcerative colitis, and chronic hepatitis, tracking the required monthly clinical staff time and physician supervision requirements to compliantly bill CPT 99490 and 99491.

How does the system handle anesthesia billing for GI endoscopy by gastroenterologist-directed CRNA?

We support gastroenterology anesthesia billing by tracking exact case start and stop times, calculating anesthesia base units per CPT code, and verifying concurrency rules when gastroenterologists medically direct multiple CRNA rooms simultaneously, a common source of audit exposure in high-volume GI practices.

Gastroenterology PM & RCM Software

Gastroenterology Practice Management and RCM Billing, Built to Perform

Streamline split-facility fees, preventative screening modifier transitions, and pathology lab results charge triggers. See why gastroenterology practices choose Unlimited Systems for practice management and RCM software.

Why Gastroenterology billing is different

Gastroenterology clinics face intense workflow splits between outpatient clinical consultations, on-site pathology laboratories, and complex Endoscopy/Colonoscopy procedures performed at separate ambulatory surgery centers.

A screening colonoscopy that transitions into a diagnostic procedure (due to microscopic snare polypectomies) must be processed with meticulous modifier sequencing (e.g., -33 or -PT modifiers). Mismatching these codes triggers patient balance errors and hefty Medicare rejections.

Cost Savings Calculator

★★★★★4.8/5

★★★★★5/5

6,500+ specialty providersSOC 2 certified

Surgical team in masks looking down before a procedure

Product screenshot

Gastroenterology workspace preview coming soon

HOME SPECIALTIESGastroenterology RCM Software

Trusted Payer & EHR Integration Partners

6,500+

providers nationwide

$70B+

in claims processed annually

4.8/5

average client rating

Designed Around How Your Gastroenterology Practice ACTUALLY Works

Our connected workflows are built to make you and your work easier to do and increase your revenue.

Visit-ready

Keep authorization and coverage aligned before the appointment is booked.

Claim-ready

Validate gastroenterology codes, modifiers, and documentation before submission.

Practice-ready

Give teams one view of denials, margin, and A/R priorities.

Specialty RCM intelligence

Gastroenterology Revenue Cycle Challenges

IBD biologics and infusion services are the fastest-growing revenue risk.

17%

Est. denial rate

8/10

Prior-auth burden

Where revenue is at risk

IBD Biologic Complexity

Remicade, Entyvio, and Stelara require step therapy from steroids or immunomodulators for many payers.

How the platform addresses this

Native prior authorization integration eliminates manual PA queues.
Step-therapy history attaches to the request from the clinical record.
Dose escalation is validated against payer policy.

See it on your own claims

Buy-and-bill drug reference5 agents · codes, channel, prior-auth, and billing notes

Drug	Code	Route	Channel	Cost	PA	Billing notes
Entyvio (vedolizumab)	J3380	IV	Part B	$22K/yr	Yes	Step therapy from Remicade often required.
Stelara (ustekinumab)	J3357	IV then SQ	Part B/D	$55K/yr	Yes	IV induction then SQ maintenance creates channel shift.
Remicade (infliximab)	J1745	IV	Part B	$26K/yr	Yes	Biosimilar substitution rules vary by payer.
Skyrizi (risankizumab)	J0222	IV then SQ	Part B/D	$55K/yr	Yes	Newer IV induction; payer policy evolving.
Tysabri (natalizumab)	J2323	IV	Part B	$59K/yr	Yes (TOUCH)	Crohn's indication; REMS adds burden.

Cabinet integration: GI infusion suites are growing quickly. Without cabinet-to-EHR integration, manual infusion logs miss administration code add-ons and fail to capture infusion duration accurately for high-value IBD drugs.

AI + Automation

AI & Automation for Gastroenterology

Screening-to-diagnostic colonoscopy reclassification applies automatically from the procedure note.
Facility and professional fee splits calculate automatically by site of service.
Anesthesia coding is checked against the documented procedure before submission.
Work by exception surfaces only the claims with an actual classification conflict.

Explore AI for Gastroenterology

Real Gastroenterology Practices, Real Results

See how gastroenterology groups across the country use Unlimited Systems to lift collections, cut denials, and reclaim staff time.

Featured Practice

Gastroenterology Partners of the Midwest

Columbus, OH14-provider group practice

“Unlimited Systems gave our gastroenterology billing team the specialty-specific automation we could never get from a generic platform. First-pass claim acceptance climbed fast.”

- Director of Revenue Cycle

23%

Fewer denials

11 days

Faster A/R

Calculate Your RCM Revenue Leakage

Drag the sliders to estimate how much unrealized cash remains locked in your current specialty billing cycles before optimization.

Model your current claim volume

Adjust both inputs to match your practice.

Monthly specialty claims1,500

200 claims15,000 claims

Average claim value$250

$80 value$3,500 value

Estimated annual revenue recovered

$315,000

Calculated using a 7.0% reduction in write-offs from rejection recovery, pre-authorization verification, and drug-waste capture.

Monthly invoiced volume: $375,000
Standard industry loss: $31,875

Unlimited Systems Guarantee: Fully integrated bi-directional EHR triggers maintain first-pass bill submission scores above 98.6% across regional payer rules on day one.

Review my results

See your recovery estimate

Enter your work email to unlock your estimated annual recovery.

See Your Results Immediately5/55/54.8/5

One platform for every gastroenterology workflow

Eight connected capabilities, grouped around the way your practice works.

Front office

Keep registration and appointment calendars in sync.

Patient intake Scheduling

Before the visit

Verify coverage and catch charge risk early.

Financial clearance Charge validation

Revenue cycle

Post payments, route denials, and prioritize A/R.

Payment and denials A/R management

Practice intelligence

See margin, performance, and value-based results.

Analytics Value-based care

The Gastroenterology suite

Every part of the gastroenterology revenue cycle, in one system

Each module is configured for the codes, modifiers, and payer rules gastroenterology teams work with, not adapted from generic billing software.

Gastroenterology Patient Intake SoftwareValidate primary benefits and capture patient screening waivers prior to clinical check-in.Gastroenterology Scheduling SoftwareSchedule endoscopy rooms, anesthesia specialists, and recovery chairs in unified grids.Gastroenterology Financial Clearance SoftwareCrossverify outpatient indications against local carrier guidelines for biological colitis drugs.Gastroenterology Charge Validation SoftwareEnforce correct -33 and -PT modifier additions based on operative findings and pathology triggers.Gastroenterology Payment Posting SoftwareAutomatically divide and post complex remittances between surgical facilities and physicians.Gastroenterology AR Management SoftwareTrace slide timing margins to appeal denials, matching biopsy specimens and results.Gastroenterology Analytics SoftwareView net yields and profit margins per endoscopist, facility, or CPT grouping.Gastroenterology Value-Based Care SoftwareDeliver clinical data regarding adenoma detection rates to MIPS database grids.

The cost of generic billing

You went into gastroenterology to treat patients, not to chase claims

These are the places gastroenterology practices most often lose revenue when their billing platform wasn’t built for the work. Unlimited Systems closes each one with rules configured for your specialty.

Review your workflow

Common gastroenterology revenue leaks

Frequent denials on preventative colonoscopy conversions (CPT 45385).
Undetected loss of pathology facility fee components on secondary biopsy slides.
Difficulty balancing complex anesthesia timing blocks and concurrency calculations.
High outstanding accounts receivable on high-frequency in-office infusions.

Challenges we solve for gastroenterology

The work that generic platforms leave to your staff is the work gastroenterology margin actually turns on.

Preventative-to-Diagnostic transitions

Operative note ingestion automatically appends preventative conversion modifiers to clear copay margins.

Professional/ASC Fee Splitting

Single charge entry generates separate professional and facility claims simultaneously.

Anesthesia Time Processing

Extracts exact anesthesia start-stop intervals directly from clinical flowsheets.

Legacy software vs. Unlimited Systems

See why gastroenterology practices move off general-purpose billing platforms.

CRITERIA

LEGACY SYSTEM COMPROMISE

UNLIMITED SYSTEMS VALUE

Preventative-to-Diagnostic transitions

✕Claims get billed as standard diagnostic, causing unexpected patient out-of-pocket balances.

✓Operative note ingestion automatically appends preventative conversion modifiers to clear copay margins.

Professional/ASC Fee Splitting

✕Requires manual input across separate billing screens for clinics and surgical wings.

✓Single charge entry generates separate professional and facility claims simultaneously.

Anesthesia Time Processing

✕Inaccurate timing conversions lead to significant anesthesia billing audits.

✓Extracts exact anesthesia start-stop intervals directly from clinical flowsheets.

Still evaluating

Not Ready to Switch Yet? That's Exactly When to Start the Conversation.

You don't have to be actively replacing your current system to have a useful conversation with Unlimited Systems. Many gastroenterology practices talk with us months before a contract renewal or system evaluation to understand where IBD biologic authorization, infusion room billing, endoscopy coding, and pathology coordination may already be showing up.

Get a Demo Benchmark Your Current Workflow

A conversation can help surface where IBD biologic step therapy, infusion administration add-ons, endoscopy unbundling risk, and pathology professional/technical splits may be reducing your capture rate.

Less billing work between the visit and payment

Specialty rules and connected data keep your team focused on the exceptions that need judgment.

Verify before the visit

Coverage and authorization stay tied to the order.

Validate specialty charges

Code, unit, and modifier checks happen before filing.

Work the right accounts

Denials and A/R are ranked by value and filing risk.

Care team in scrubs walking through a clinic corridor

35%less manual workflow time

One platform

The rest of the platform your gastroenterology practice runs on

The same connected system handles the operational work that sits either side of billing.

Patient Intake

Digital intake, eligibility, and demographic capture before the visit.

Explore Patient Intake

Patient Scheduling

Smart calendars and resource scheduling across providers and locations.

Explore Patient Scheduling

Financial Clearance

Automated eligibility checks and prior authorization management.

Explore Financial Clearance

Charge Validation

Pre-claim scrubbing for coding, modifiers, and compliance accuracy.

Explore Charge Validation

Built for gastroenterology

Follow one gastroenterology patient from intake to payment

Eight stages, one record. Nothing is rekeyed between systems, so a detail captured at the front desk is still there when the claim goes out, and when the remittance comes back.

Walk the workflow with us

Frequently asked questions

We map outpatient pathology systems directly to charge logs, triggering tissue-block units based on specimen registrations.

New to revenue cycle terminology? Browse our healthcare RCM & billing glossary.

We Love Hearing From Our Users

Practices like yours, on what changed after moving to Unlimited Financials.

EXPLORE PRODUCTS GET A DEMO

★★★★★4.8/5

★★★★★5/5

“

I'd love to set up a call to talk about SCOA, and the success we've had with Unlimited Financials.

Sam Wheeler

CFO, SCOA

“

The system continues to grow with features as it should, with how healthcare changes. So, if you are looking for a company that is innovative and truly cares, I would recommend Unlimited Financials.

Ernelita Dacumos

Billing Manager, SHOM

“

Unlimited Financials has been the easiest and best practice management system I have used. It is easy to navigate and do what I need to do.

Melissa Shook

Medical Biller, SHOM

“

I would recommend Unlimited Financials to other specialty practices.

Michelle Leandri

CEO, NEPA

“

We transitioned to Unlimited Financials in 2024... the team and platform are absolutely amazing.

Gina

Administrator, FOUR

“

We have been on Unlimited Financials for over three years and love it. Our claims are being processed faster and more efficiently, which means we are receiving payment more quickly.

Renee Bernacchi

Accounts Receivable Coordinator, COAS

“