Who We Serve/Gastroenterology

Gastroenterology practicesrun on volume. We show you where it is being lost.

Multi-site GI practices — whether independent or PE-backed — share the same core problem: data across systems that cannot communicate, cancellations that cannot be decomposed, and payer contracts that have never been reconciled against actual payments. Prexisio builds the connective layer.

Built from a real GI engagement

A client in the North East was a PE-backed management services organization that had acquired multiple gastroenterology practices across different markets, each on a different system.

Prexisio built the integration layer across all acquired practices, delivered three recurring monthly reports — AR aging, monthly billing, and payer mix — without manual assembly, and managed the annual MIPS submission across the organization.

The engagement ran through the full operating period until the client was acquired by SCA Health, a subsidiary of Optum.

3

Recurring monthly reports delivered on schedule every cycle

Multi

Acquired GI practices unified under one reporting layer

Annual

MIPS submission managed across the full organization

What the diagnostic covers for GI

ASC throughput and endoscopy case stacking

D4 + D5

GI ASCs run on volume. Case stacking efficiency — how many colonoscopies and upper endoscopies move through each room per day — directly determines capacity utilization and revenue. D4 and D5 map patient flow and OR efficiency at the procedure level.

Cancellation decomposition for endoscopy scheduling

D1 + D2

Patient prep failure is the leading cancellation cause in GI — but it is not the only one. Prior auth for complex procedures, scheduling gaps, and referral source quality all contribute. D2 decomposes every cancellation so the fix matches the cause.

PE consolidation — multiple systems, one view

D1

PE-backed GI groups acquire practices on different systems with different patient IDs and different payer contracts. Before any cross-practice analysis is possible, those systems must be connected. The patient identity bridge across acquired practices is the first deliverable for every PE GI engagement.

Payer mix optimization across acquired practices

D7 + D8

Different acquired practices often have different payer mixes and different contracted rates for the same CPT codes. D8 produces the cross-practice payer mix profitability view that informs contract renewal strategy and BD allocation.

Referral source quality for GI pipeline

D6

Not all referring providers send equal-quality cases. D6 ranks every referral source by volume, cancellation rate, and net revenue per case — identifying which relationships drive the highest-margin, lowest-cancellation endoscopy volume.

MIPS and regulatory reporting

Regulatory

Annual MIPS submission requires pulling quality measure data across all practice locations. Prexisio has built and delivered MIPS submissions for multi-practice GI groups.

Systems we work with in GI

GI practices run on a variety of EMR and billing platforms. The patient identity resolution logic and field verification are calibrated to each system.

ModMed (Modernizing Medicine)

Primary EMR for many GI practices — scheduling, encounters, billing

AdvancedMD

Practice management and billing at independent GI groups

Nextech

EMR and practice management at some multi-specialty GI organizations

HST Pathways

ASC platform for GI organizations with ambulatory surgery centers

Find out what your GI practice is leaving on the table.

Three inputs. Thirty seconds. A specific monthly dollar amount.