Maximize Reimbursements with Specialized OB/GYN Medical Billing Services
Maximize reimbursements with our OB/GYN medical billing services and get 99% clean claim rates for women’s health practices. We understand your need to keep things small, intimate, and personalized, which is why our medical billing specialists for independent small practices thoroughly study your needs and offer custom-made solutions.
Preventing Revenue Loss in OB/GYN Practices
Statistics show why 68% of OB/GYN private practices lose 15-30% of their revenue to these preventable issues. To address this, we provide specific fixes for common coding errors:
- Global OB Packages: Misusing global OB packages (59400-59430) or splitting prenatal/postpartum care incorrectly causes 35% claim denials. Our Fix: OB-certified coders achieve 96% accuracy in global fee billing.
- Complex Procedures: Missing mod-22 for complex procedures (58150-58679) or bundling errors leaves $12k+/year unclaimed. Our Fix: Surgical billing specialists capture 98% of eligible charges.
- Postpartum Care: 68% of practices miss billing for 59430 postpartum care and lactation support (S9443), losing $8k+/practice. Our Fix: Automated postpartum visit tracking recovers 92% of missed services.
- High-Risk Medicaid: State-specific rules for high-risk pregnancy programs (Z3A codes) result in 42% claim rejections. Our Fix: 50-state Medicaid OB specialists ensure 100% compliance.
- Well-Woman Visits: Improper Well-Woman Visit coding (G0101, Q0091) with problem visits triggers 30% payment delays. Our Fix: Preventive care modifiers (-25, -59) applied with 94% accuracy.
Comprehensive Coding and Billing Specializations
Global Maternity and Postpartum Optimization
Our team ensures precision coding for complete prenatal-to-postpartum care (59400-59430) including high-risk pregnancy modifiers (22) and Medicaid extension programs. We allow you to capture all 59430 eligible visits up to 12 months postpartum, including lactation support (S9443) and comorbid condition coding (O26.9), which recovers $15k+ per practice annually. With a specific postpartum care focus, we optimize billing for 59430 and lactation support (S9443).
Gynecologic Surgery and Urogynecology
We provide end-to-end billing for hysterectomies (58150-58579), laparoscopies (58662), and colposcopies (57452-57461) with tissue pathology linking. Our OB-Specific Coders are experts in gyn surgery (58150-58679) and reduce denials by 60% for complex procedures. Furthermore, we provide accurate billing for pelvic floor therapy (97032), pessary management (57160), and sling procedures (57288) with proper -22 modifier application.
Fertility and Reproductive Health
For specialized practices, we offer coding for IUI/IVF monitoring (S4021), HSG tests (58340), and genetic screening (81228). This includes prior auth management for fertility medications, ensuring that ASRM-compliant coding increases reimbursements by 35% even as incorrect use of ART codes (58970-58976) causes 45% denials for REI practices.
Our Revenue Cycle Management Process
- Requirement Analysis: We begin by determining your practice’s needs, goals, and billing process.
- Patient Registration & Verification: Next, we collect all the relevant information about the patient and verify his insurance coverage with pre-eligibility checks.
- Claims Submission & Scrubbing: Our specialists verify codes (CPT, ICD-10), check documentation, and scrub claims for errors to ensure clean claims are electronically submitted within 24-48 hours.
- Payment Posting & Follow-Up: We track all claims through payer adjudication, post payments/EOBs to your system, and proactively follow up on delayed or denied claims.
- Reporting & Revenue Optimization: Monthly performance reports identify reimbursement trends and coding opportunities to recommend fee schedule adjustments.
Technology and Practice Integration
Our solutions offer seamless EHR integration with Nextech, eClinicalWorks OB, and Epic OB. We handle efficient Electronic Funds Transfer (EFT), EDI, and ERA setups, alongside free CAQH maintenance and provider revalidation. You can track every claim, secure every dollar, and control your revenue while our VAs help you say goodbye to staffing woes.