September 09, 2013
Many will tell that gynecology has benefitted from being part of OBGYN as it helps gynecology to operate closely with obstetrics, a natural partner when it comes to pregnancy. But gynecologists may argue that while it may be true from a medical standpoint, when seen from a financial point of view, one can get a different picture.
Since the introduction of OBGYN, it is widely believed that OBGYN has been responsible for the increasing costs gynecologists have to contend with. And this observation is one not without reason as it has been found that OBGYN care providers lose at least 20 percent of their collectable revenues because of claim denials and underpayments resulting from inaccurate coding.
It can be said that half of this loss is suffered by obstetrics, but there is a key difference between obstetrics and gynecology. Gynecology involves around 12 tests and only some of them are for pregnancy. It means the discipline has to deal with more procedures and codes translating into costs for carrying out services and the need to use accurate codes and follow additional procedures (like records to documents the tests accurately) to claim reimbursements for them.
The role of gynecology extends far beyond the contours of pregnancy and therefore OBGYN. And even in these areas, gynecologists have to handle complexities when it comes to treating patients under various programs introduced by medical authorities. Discussing some of them will clarify how they can lead to claim denials for lack of policy awareness as well as inaccurate coding. For some time now, Medicare allows Annual Wellness Visits (AWV) but many providers confuse AWV with annual Well Woman Exam (WWE) and bill for AWV without evaluating a patient for WWE. This happens because the components covered by them are very similar (but not same).
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MBC’s Revenue Management Consulting services can help you with this by assessing your in-house revenue management cycle and ensuring that there is sound coordination between various components of healthcare facilitating smooth flow of medical data. Additionally, MBC identifies gaps in your process and addresses them by performing a series of activities as required, like helping replace old software applications with new ones, blocking areas of revenue leakage and identifying areas of staff training. The outcome of this would be a nimble revenue cycle management process capable of meeting all documentation and operational needs of preparing and submitting claims successfully aided by in-house billing and coding staff proficient in terminologies and procedures of healthcare policies that apply to gynecology.
Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has also been helping several hospitals, in big and small cities of the US, with its Outsourcing services handling the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. We track unpaid and underpaid claims and re-appeal them as also answer questions asked by insurance companies. Our services have caused increase in collections by seven to 10 percent for gynecologists. You can also pick and choose such parts of our services as fit your billing and coding needs and pay for exactly what you need.