Effective OBGYN Billing Solutions for Optimal Results
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Overview of
OBGYN
Medical Billing Services
Obstetrics and Gynecology (OBGYN or OB/GYN) is an indispensable medical specialty, offering holistic health support to women at all stages of their lives. As a combination of two specialties, OBGYN is multifaceted. Specialists use a mix of medicines and surgeries to treat conditions like menopause, infertility, hormonal disturbances, contraception, and cervical cancer and ensure quality pre-natal, intra-natal, and post-natal care.
OBGYN providers are constantly shuffling between consulting rooms, delivery rooms, and neonatal intensive care units (NICU) to manage the intricacies of their patients’ reproductive care. The dynamic and demanding nature of OBGYNs’ work hardly leaves any time for untangling the complexities of medical billing. However, entrusting OBGYN billing to a credible third-party billing services provider can make their life easier.
Advanced
Laparoscopic
Surgery
Family
Planning
FPMRS
Gynecologic
Oncology
Maternal-Fetal
Medicine
Menopausal &
Geriatric
Gynecology
Minimally Invasive
Gynecologic
Surgery
Pediatric &
Adolescent
Gynecology
Reproductive
Endocrinology
& Infertility
Urogynecology
Common Challenges in OBGYN Medical Billing
In the USA, obstetricians and gynecologists have a burnout rate between 40% and 75%. They often sacrifice their sleep, meals, and family time to look after their patients’ physical, mental, and emotional well-being. On top of that, they manage hours of paperwork for claims submission and revenue collection.
But the real whirlwind strikes when issues like bundled services, revised coding guidelines, differing payer policies, and documentation requirements exacerbate the OBGYN billing blues. Providers must overcome these challenges to ensure clean claim submission, prevent denials, and optimize their practice’s revenue cycle.
Global Maternity Care
Government and private insurers often bundle antepartum, intrapartum, and postpartum services in a package known as the Global Maternity Care. OBGYN billing experts must create one claim to seek payment for all these services instead of billing them separately. Therefore, appropriate CPT codes should be used for global maternity billing.
Varying Insurance Coverage
Verifying a patient’s insurance coverage can be a hassle. Insurance coverage for OBGYN services varies from payer to payer. While most insurers cover maternity care, birth control, and medications like vitamins and supplements, complex procedures and treatments like in vitro fertilization (IVF) and elective abortions may not be covered.
Place of Service Coding
OBGYN services are provided at multiple facilities, ranging from clinics to hospitals. During claims creation, providers are required to enter the code for the place where the service was offered, e.g., 49 for an independent clinic. Incorrect or missing POS codes can result in claim denials.
Changing Code Sets
The CPT code sets are issued and revised by the American Medical Association (AMA) annually. Revisions are in line with modifications and innovations in the current medical procedures. OBGYN providers may struggle to keep up with the changing code sets and use outdated codes, resulting in denials.
Outsource OBGYN Billing Services to MediBill MD
Are non-clinical aspects of your practice keeping you away from connecting with your patients and understanding their pain points? Then, it is time to look for a credible OBGYN medical billing company. By partnering with professionals like MediBill MD, you can divert your time and energy to fostering meaningful relationships.
Our OBGYN billing staff thoroughly analyzes your practice’s financial performance before suggesting custom-made services. At every step of the process, you receive timely guidance from our billing specialists, who dedicate their day to maximizing your payment collections and optimizing your revenue cycle. Try our proven solutions to empower your practice!
At MediBill MD, we offer tailored OBGYN medical billing services at some of the lowest market rates. You are only required to pay a small percentage of your total monthly collections. Moreover, outsourcing OBGYN billing to MediBill MD can save you from the costs of maintaining an in-house billing team.
We expedite the process of obtaining prior approvals for OBGYN procedures and services to ensure accurate and timely reimbursements by the payers. Our billing staff works round the clock to get pre-authorizations for surgeries in 24-48 hours. Without our assistance, the process could drag on for weeks.
We are 100% HIPAA compliant and take data privacy seriously. Our files are end-to-end encrypted, ensuring complete protection against data breaches. You can rest assured that your financial details and the patient's health information (PHI) stay safe with us.
We are committed to your goal of providing quality reproductive care to women of all ages. Our processes are designed to streamline your billing workflow, freeing up your time and optimizing your cash inflow so you can enhance patient satisfaction.
Our team of AAPC-certified coders have years of experience in medical billing. Apart from being expert billers, they are skilled communicators and act as a bridge between you and the insurance payers. Be it day or night, rain or sunshine, they are always ready to address your OBGYN billing needs.
Our billing team understands the broad scope of OBGYN diagnoses, procedures, and services. They are well aware that while some insurance payers and plans may cover several OBGYN services, the rest will offer coverage for a handful of procedures. Hence, they conduct stringent checks to verify a patient’s eligibility.
Unlock MediBill MD’s nationwide reach and local expertise. It doesn’t matter if you are a clinical gynecologist in Palo Alto or a maternal-fetal medicine expert in Boston - from coast to coast, we have got you covered!
Our OBGYN billing specialists will follow your state’s law to ensure compliant claims submission. And don’t even bother checking the clock. We are open 24/7, serving OBGYN practices in all time zones.
Overcome OBGYN Billing & Coding Errors with MediBill MD
Medical billing is a time-consuming and daunting process. On average, physicians spend 1-4 hours per day to file and manage claims. However, OBGYN billing raises the difficulty bar with multiple visits spanning over months, global and non-global billing, and overlapping obstetric and gynecologic procedures.
It can be difficult for OBGYN providers to submit error-free claims when the codes keep changing, payers keep revising their policies, and procedures require modifications to suit specific circumstances.
| Common OBGYN Billing Challenges | MediBill MD Solution | |
|---|---|---|
| Bundling Pre-Natal and Intra-Natal Care | Most payers bundle pregnancy, childbirth, and postpartum care under a global package. Our billing staff ensures that one clean claim is submitted to collect this big amount. | |
| Using Incorrect Place of Service Code Set | OBGYN services are offered at multiple facilities. Our team prioritizes adding the correct code for the place where the service was offered, e.g., 25 for the birthing center. | |
| Billing Uncovered Services | Some OBGYN services, like elective abortions and IVF, are usually not covered by payers. Our team vigilantly determines the patient’s eligibility, preventing you from claim denials. | |
| Missing Documentation for Antepartum Care | It can be difficult to remember and provide all the documents generated over 9 months to the insurance payers for global maternity reimbursement. Our team keeps track of that. | |
| Missing or Incorrect Modifiers for Reproductive Surgeries | Reproductive surgeries often require modifications to the procedure, which are highlighted by modifiers. Our coders use the correct modifiers to inform payers about these changes. | |
| Double Billing for Twins | Over 75% of twins are delivered through cesarean. Our OBGYN billing experts create one claim for the C-section and use modifier 22 to report the delivery of 2nd twin. | |
| Billing Multidisciplinary Care for Women with High-Risk Pregnancies | For interdisciplinary care, e.g., a pregnant woman receiving treatment for cervical cancer, our team closely works with all the physicians/specialists involved and creates separate claims for unbundled service. | |
At MediBill MD, we guarantee the highest returns at the lowest costs. Our suite of tailored OBGYN billing services is designed to uptick your practice's revenue while reducing administrative burdens, all at an affordable price!
Price Comparison Calculator
Based on your annual collections, we will calculate the in-house medical billing cost and compare it with the MediBill MD service charges.
Get In Touch with an
OBGYN Billing Experts
Let's partner up to transform reproductive care for the USA’s 50.5%! Contact our OBGYN billing team and offload your financial burdens so you can commit to excellence in patient care.
FAQs
At MediBill MD, we are committed to providing 24/7 expert assistance for OBGYN billing at affordable rates. Our certified coders and billers streamline your administrative workflow to ensure you provide the best quality healthcare to young girls and women.
Outsourcing OBGYN billing is cost-effective compared to maintaining an in-house billing team. We only charge 2-5% of your total monthly collections, saving you from overhead costs like hiring certified coders, purchasing billing software, setting up an office, etc.
Coding is the biggest challenge associated with OBGYN medical billing. With hundreds of CPT codes for OBGYN office visits, screenings, in-patient care, surgeries, and outpatient treatments, it can be a challenge to report the correct code, especially when you have to distinguish between obstetrics and gynecology code ranges, adhere to the annual revisions in CPT code sets, and add the appropriate modifiers for highlighting changes to the reported procedures.
