OBGYN Medical Billing Services
Global obstetric packages, antepartum and postpartum splits, deliveries and gynecologic surgery.
Obstetric care is billed as one global package covering months of care. That makes it the easiest specialty to lose money in quietly. A patient who transfers in, transfers out or delivers elsewhere breaks that global. Those visits then have to be unbundled and billed one by one, or they are never paid at all. Our obgyn medical billing services watch for broken globals as they happen.
Practices comparing obgyn billing services should also ask about Medicaid, which pays for a large share of births. You enrol with the state programme first, then with each managed care plan on its own. A credentialing gap mid-pregnancy is expensive, because the care is already being given.
Our Services
OBGYN Is Easy to Get Wrong
OBGYN billing is widely misunderstood, and that shows up in the accounts receivable, in collections and across the revenue cycle.
The work needs people who have done OBGYN billing and coding. That is what we provide, and it is why our obgyn billing services hold up over time rather than just at the start.
What benefits are provided by our Obstetrics and Gynecology Billing and Coding?
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Subject Matter Experts (SMEs):
Due to the vast scope of both obstetrics and gynecology (OB/GYN), not every billing and coding company can handle the intricacies involved. This poses a challenge that we approach with utmost seriousness. It is evident from our commitment to maintaining the highest quality that we have assembled a highly competent team of billers and coders, ensuring excellence in our services from the outset.
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Strict Reporting:
Be assured that Cure CloudMed highly values your business, mirroring your dedication. In our journey, our commitment stands as a pivotal factor, contributing to our success. Among various success factors, proactive reporting plays a crucial role. We make it a priority to carry out reporting proactively, ensuring transparency. Even in less favorable situations, we communicate on the agreed-upon date. This approach emphasizes our belief in timely communication, saving both your and our time for more productive endeavors.
Procedure
Medical coding and billing for a full range of obstetrics and gynecology procedures, executed with equally proficient expertise:
- Pelviscopy
- Pelvic Ultrasound
- Selective Salpingography
- Oophorectomy
- Suspensions Uterine Vaginal Vault
- Myomectomy
- Toluidine Blue Dye Test
- Hysteroscopy
- Trachelectomy
- Hysterosalpingography
- Tubal Ligation
- Hysterectomy
- Uterine (Artery) Fibroid Embolization (UFE)
- Fluid-Contrast Ultrasound (FCUS)
- Vulvectomy
- Adhesiolysis
- Endometrial or Uterine Biopsy
- Cervical (Cone) Biopsy
- Endometrial Ablation
- Colporrhaphy
- Dilation and Curettage (D&C)
The obstetric package and when to break it
Obstetric billing is unusual because most of the care is paid under one global code at the end, months after the work started.
What the global package includes
The global obstetric code covers routine antenatal visits, the delivery itself and routine postnatal care. Billing the individual visits as well is duplicate billing. The package does not cover the initial visit that confirms the pregnancy, problems unrelated to the pregnancy, or complications that need extra work.
When the global code is the wrong choice
The package assumes one practice provided all of the care. It frequently does not happen that way.
- A patient who transfers in or out part way through is billed for the portion of care actually provided, using the antenatal only codes and the delivery code separately.
- A patient who moves, changes insurer or miscarries leaves an incomplete package. Billing what was done is correct and is often missed entirely.
- Where the practice provides fewer than the threshold number of antenatal visits, the visits are billed individually rather than as a package.
Practices lose real money by waiting for a global code that will never be billable.
High risk and complications
Extra visits for a complication such as gestational diabetes or hypertension are billable outside the package when the record shows the additional work and links it to the complication. So are non stress tests and fetal biophysical profiles, each with its own code and its own frequency expectations.
Ultrasound is coded by what was done
There are different codes for a first trimester scan, a detailed anatomy scan, a follow up or limited scan, and a transvaginal scan. The report has to document the elements the code requires. A limited scan billed as a complete one is a common finding on review, and the fix is usually a report template rather than a coding change.
The gynaecology side
A well woman visit and a problem visit on the same day are both billable with the right modifier, when the problem work stands on its own in the note. This is the same rule as the rest of medicine and it is missed for the same reason.
OBGYN Credentialing, Hospital Privileges and Medicaid Programs
OBGYN credentialing turns on one thing above all: hospital privileges. No privileges, no deliveries. Each hospital grants them on its own schedule, and the process is slower than payer enrollment. Start it first, not last. Where you take call at more than one hospital, that is one application each.
Medicaid matters more here than in most specialties, because Medicaid pays for a large share of births in every state. You enrol with the state programme first, then with each managed care plan on its own. Miss the second step and the plan denies the claim even though the state approved you.
We handle privileging, commercial enrollment and the full Medicaid chain together. See our medical credentialing services.