GASTROENTEROLOGY PRACTICE · Southern, US
Eliminated patient billing complaints from screening-to-diagnostic colonoscopy conversions
A gastroenterology group performing high volumes of screening colonoscopies needed to correctly handle conversions to diagnostic procedures without generating unexpected patient bills.
Client: [Client Name Placeholder]
The Challenge
[Placeholder] When a screening colonoscopy converted to a diagnostic procedure due to a polypectomy or biopsy, claims were frequently submitted without the correct preventive-to-diagnostic modifiers. This caused patients to receive unexpected coinsurance bills, generating a steady stream of billing complaints and write-offs while staff manually reworked claims after the fact.
The Solution
[Placeholder] Unlimited Systems configured automated modifier logic that reads operative findings and applies the correct preventive conversion modifiers (-PT/-33) before claims are submitted. The platform also split professional and ambulatory surgery center facility billing automatically from a single charge entry, reducing manual rework across departments.
The Results
89%
Reduction in patient billing complaints related to screening conversions
31%
Decrease in claim denials on converted colonoscopy procedures
$142K
Annual revenue recovered from previously underbilled conversion claims
4 days
Faster average claim submission after procedure
“[Placeholder testimonial] Patient complaints about surprise bills used to be a weekly occurrence. Since Unlimited Systems automated our conversion modifiers, that's essentially disappeared.”
[Placeholder Name]
Director of Patient Financial Services, [Gastroenterology Practice Placeholder]
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