Obstetrics & Gynecology is a  branch of medicine specializing in women’s care during pregnancy and childbirth and diagnosing and treating female reproductive organs’ diseases. It also specializes in other women’s health issues, such as menopause, hormone problems, contraception (birth control), and infertility.

An OB/Gyn practice does various procedures ranging from surgeries, pre & postpartum healthcare, and regular health screenings for women.

Complexities in OB/GYN billing

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Ob/GYN billing & coding can be challenging to most billers & coders due to the global claims, widely varying coverage terms, and multiple tests performed at numerous facilities. Apart from this, many OB/GYN practitioners lack the billing support provided to large hospitals. Here are a few standard billing & coding errors that occur in OB/GYN billing & coding:

  • Overlooking separately billable services rendered during the global period
  • Lack of understanding that pregnancy coverage is an amendment to an existing insurance plan
  • Pregnancy coverage includes inpatient & outpatient services and is split between them.
  • Improper documentation of the policies & services provided
  • It requires a clear understanding of the criterion that determines the “medical necessity” to code for the various levels of ground and air ambulance services used.
  • Understanding that all laparoscopic OB/GYN surgical procedures involve diagnostic laparoscopy

Medical Billing Wholesalers Expertise in OB/GYN Billing & Coding

At MBW, we have a client base that extends across all 50 states, covers a wide range of hospitals, physician practices(including OB/GYN), and medical billing companies. Our team of OB/GYN billers & coders employ their experience and knowledge acquired through a decade of working with obstetricians & gynecologists, improving your revenue & accelerating growth. WeCare RCM coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and are certified by the American Academy of Professional Coders (AAPC). Our expertise in OB/GYN billing & coding covers specialties including:

  • Maternal-Fetal Medicine
  • Reproductive Endocrinology and Infertility
  • Gynecological Uro-gynecology and Pelvic Reconstructive Surgery
  • Advanced Laparoscopic Surgery
  • Family Planning
  • Pediatric and Adolescent Gynecology
  • Menopausal and Geriatric Gynecology

Applying best practices for OB/GYN Billing & Coding Services

At MBW, we recognize the challenges faced by OB/GYN providers, such as rapidly changing policy rules, ICD updates, and the sensitive nature of your specialty. Our certified coders are capable of choosing appropriate codes from operative reports of real-life surgical cases. We work with you 24/7 to prevent problems caused by incorrect use of modifiers, as well as educate your in-house billing specialist on how to avoid them.

Our professional billing & coding experts work to prevent claim denials while increasing the number of reimbursements. We do this by focusing on efficient, streamlined processes that decrease the amount of time needed to correctly bill for Ob/Gyn services.

We have built our approach by adhering stringently to coding guidelines & bests practices and applying modern technology. The MBW team focuses on providing data-driven solutions that help reduce denials and increase revenue.

Benefits of our OB/GYN Billing and Coding Services

We bring finesse and accuracy to our OB/GYN billing and coding services while building a flawless reimbursement process for your practice. With patient demographics entry, insurance verification, insurance authorizations, coding, billing, and reconciling of accounts, our medical billing process can add value to your organization. We ensure consistent accounts receivable follow-up and prior authorization to avoid claim denials.

Our denial management team’s #1 priority is shifting your focus from denial management to denial prevention. Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process.  We bring you a group of specialists who are:

  • Certification from The American Association of Professional Coders (AAPC)
  • Familiar with medical billing software such as eClinical Works, Allscripts, Athena, Lytec, Medic, Misys, Medisoft, NextGen, and many more
  • Coders trained in coding software such as EncoderPro, FLashcode, CodeLink, etc
  • Being able to apply standard CPT, HCPCS procedure and supply codes, and ICD-CM diagnosis coding as per CMS guidelines
  • We maintain a successful track-record of processing medical bills with leading commercial carriers such as United health, WellPoint, Aetna, Humana, HCSC, Blue Cross Group, etc.
  • We provide uncompromised ability to negotiate successfully with Medicare and state-specific Medicaid policies.

Our clients typically see an improvement in revenue by 30% and a reduction in denials by a minimum of 10%. We achieve this by applying our expertise, process rigor, latest technology and by employing an excellently trained team.