ASC Billing Services Alert for GI Prior Authorization Expansion

The expansion of prior authorization requirements for diagnostic GI scopes in ASCs is a significant shift that demands attention. It’s not “business as usual” for GI practices and ambulatory services in medical billing. Instead, it’s now an environment where every colonoscopy or endoscopy might come with an extra checklist and a waiting period for approval. While burdensome, these changes aim (at least from the insurers’ perspective) to ensure appropriate use of procedures and manage costs. For GI providers, the priority is to prevent these new rules from disrupting patient care or the practice’s livelihood.