10 Best Gastroenterology Billing Companies in Florida (2026)
A screening colonoscopy that turns into a polyp removal can produce very different claims depending on the payer, the modifiers and how the procedure note is written. That everyday reality is why gastroenterology billing is harder than general medical billing.
Florida practices add their own pressure. Many serve Medicare, Medicare Advantage and Florida Medicaid patients, and 2026 Medicare payment changes weigh on procedure-heavy specialties. So more GI groups are asking whether outsourcing billing makes sense.
Below you will find what makes GI billing different, how we evaluated companies, and profiles of ten vendors. Sirius Solutions Global publishes this guide and lists itself first; please read the ranking disclosure at the end.
What changed for GI practices in 2026
Three published Medicare changes shape GI revenue this year. Bars show the size of each change.
Conversion factor (about $33.40) |
|
| +3.26% | |
Efficiency adjustment to work RVUs for non-time-based services, including endoscopy |
|
| -2.5% | |
Average cut to ASC-based GI endoscopy payments |
| -8% | ||
Sources: CMS 2026 Physician Fee Schedule final rule, as summarized by ASGE and Becker’s ASC Review. The ASC figure is an average; your mix will differ.
Prior authorization moved faster in 2026 Since January 1, 2026, Medicare Advantage plans and Medicaid and CHIP programs must decide urgent prior authorization requests within 72 hours and standard requests within 7 calendar days, and give a specific reason for any denial. Traditional Medicare and federal-exchange plans are not covered by those timeframes. Confirm how each of your payers applies the rule. |
Quick comparison
Sirius is listed first as publisher. Companies 2–10 are in alphabetical order, which does not imply a performance ranking. Details come from each company’s public website; confirm Florida coverage and current services directly.
How we evaluated the companies
We reviewed each company’s public GI-related information against the factors below. We did not assign numeric scores, because public websites cannot support them responsibly. The weights show what we believe matters most to a GI practice.
Factor | What to look for | Weight |
Specialty and provider experience | GI-specific content; references you can call | High |
Coding support | CPT, ICD-10 and modifier knowledge; certified coders | High |
Claims management | Pre-submission edits; clean-claim tracking | High |
Denials and A/R follow-up | Root-cause review, appeals, aging reports | High |
Eligibility and prior authorization | Pre-visit checks; authorization tracking | High |
Transparency and privacy | Clear fees, contract terms, data ownership, HIPAA safeguards | High |
Credentialing | Offered directly or through a partner | Medium |
Technology and reporting | Dashboards and access to your own data | Medium |
Support and scalability | Named contact; capacity to grow with you | Medium |
The 10 companies
1. Sirius Solutions Global DALLAS, TX Sirius is a medical billing and RCM company serving 40+ states and 45+ specialties. Its workflow covers eligibility, coding review, claim submission, denial management, payment posting, A/R follow-up and reporting. Its website lists SOC 2 Type II and ISO 27001 credentials and a 98%+ clean claim rate. We list ourselves first for full-cycle coverage and published security credentials, but we are the publisher, so judge us by the same checklist. What to check: ask how the clean claim rate is measured and request GI references. |
2. MedCloudMD FLORIDA FOCUS AIMA publishes a Florida-specific GI revenue cycle page. It says its billing specialists understand GI claim rules across commercial payers, Medicare and Florida Medicaid, and it invites practices to start with a consultation. What to check: services included, reporting and pricing. |
3. Combine Health AI-ASSISTED Combine Health presents AI-assisted GI coding and billing, with published guidance on colonoscopy CPT codes, the screening vs. diagnostic distinction and common GI ICD-10 codes. What to check: how human coders review AI output and how Florida payers are handled. |
4. HPI GI RCM HPI offers GI-focused billing and RCM, emphasizing accurate claim bundling and clear patient billing communication around procedure costs. What to check: coding review process, reporting and contract terms. |
5. Invensis BROAD PROCEDURES Invensis lists GI billing and coding for endoscopy, colonoscopy, diagnostic testing and procedures such as ERCP and TIPS. Its page cites ISO 9001:2015 and ISO 27001:2013. What to check: Florida payer experience and your day-to-day contact. |
6. MedCare MSO MODULAR RCM MedCare MSO describes GI RCM from eligibility and payer approvals through coding, denial management and A/R recovery, and says services can be customized. What to check: how fees change when you add or remove services. |
7. Outsource Strategies International CODING ACCURACY OSI publishes GI coding and billing content that highlights real-time claim scrubbing, pre-submission audits and NCCI-compliant practices, alongside an AI coding tool. What to check: whether certified coders review every AI-suggested code. |
8. PGM Billing DOCUMENTATION PGM Billing has a GI billing page that stresses documentation detail, such as noting how far the scope advanced, which determines whether a procedure supports colonoscopy or sigmoidoscopy coding. What to check: scope of services, Florida experience and pricing, since public detail is limited. |
9. Practolytics DENIALS AND AUTHS Practolytics lists claims management, coding audits, eligibility verification, denial resolution and patient billing support for GI, with guidance on CPT, ICD-10 and modifiers 33 and PT. What to check: platform ownership, reporting access and contract length. |
10. Unislink SCREENING VS. DIAGNOSTIC Unislink’s GI page centers on the screening colonoscopy that becomes diagnostic and triggers a surprise patient bill, which is a frequent source of patient-balance disputes. What to check: its patient-communication workflow and Florida payer familiarity. |
Where GI claims go wrong
Pitfall | Why it happens | What a strong partner does |
Screening turns diagnostic | Findings change the service; modifiers 33 and PT and cost-sharing rules vary by payer | Reviews the indication and note, applies payer rules, warns patients early |
Bundling and biopsy coding | Same-session procedures reported without checking NCCI edits | Scrubs claims against NCCI before submission |
Authorization gaps | Rules differ by payer and plan type | Tracks requests, deadlines and appeals |
Slow follow-up | Unpaid claims age; timely filing limits pass | Works A/R by age and payer; flags deadlines |
Underpayments | Contract rates applied incorrectly | Compares remittances to contracted rates |
Your vetting checklist
• Ask for GI-specific references and talk to a practice with a similar payer mix.
• Request sample reports and confirm you own your data and can access it at any time.
• Get fees, contract length and exit terms in writing.
• Confirm HIPAA safeguards, including a Business Associate Agreement.
• Ask how coders stay current with annual CPT and payer policy updates.
• Set realistic expectations: no honest partner can guarantee outcomes.
FAQs
Why does GI need specialty billing? Screening, diagnostic and therapeutic procedures, biopsies, modifiers and pathology and facility components create more coding decision points than most office-based specialties. |
Is outsourcing right for every GI practice? No. It tends to help when internal staff cannot keep up with coding depth, denial follow-up or authorizations. Compare it with the cost of hiring and training in-house. |
How should I verify Florida payer knowledge? Ask for examples involving your specific payers, including Medicare Advantage and Florida Medicaid plans, and confirm current rules with each payer. |
Disclaimer and ranking disclosure This article is for general information only and is not legal, financial, coding, compliance or clinical advice. Sirius Solutions Global publishes this article and ranks itself #1 as publisher; that placement is not an independent ranking. Companies 2–10 are listed alphabetically and drawn from publicly available information reviewed in October 2026, so details may be outdated or incomplete. Listing is not an endorsement, and no affiliation with any company is implied. Trademarks belong to their owners. Payer policies, CPT codes and Medicare rules change; verify requirements with each payer, CMS and the AMA before acting. No results are guaranteed. To request a correction, email Info@siriussolutionsglobal.com. |
