Unique Challenges for Ob / Gyn Billing

June 27, 2014

As government regulations transform the coding and billing practices of healthcare industry, specialty and secondary care providers experience great challenges in terms of claims filing and settlement. Most medical billing and coding changes are adapted keeping primary healthcare services in mind. But specialty care like Ob / Gyn can experience atypical challenges while trying to adopt coding changes and claiming 100% claims of their billing cycle. Undoubtedly that is why most Ob / Gyn practices forfeit more than 20% of the revenue due to claim related doubts, errors and complications.

Some of the major challenges faced by medical billers and practitioners for Ob / Gyn billing are because of lack of extensive experience and expertise required for the job. They can be enlisted in the following -

  • Regular changes in procedural coverage, recommended tests and updating of terminologies used in coding
  • Lack of Ob / Gyn billing experts in the market
  • Billing service providers being unaware of diagnoses supporting each CPT
  • Process specifications to effectively appeal for denied claims and objections of insurance carriers
  • Underpayments made by insurance carriers which are difficult to detect and track
  • Complicated billing regulations for multiple procedures?
  • Underpayments decreasing the Ob / Gyn revenues collection by about 10% every year
  • Accounts payable difficult to track with pre-payments and large accounts for various procedures

Customer confusion is a vulnerability in addition to collection related complications for Ob / Gyn billing practices. With ante-partum care, post-partum care, complicated surgeries and use of modifiers the payment process becomes tedious and complex for practitioners. Engaging a specialized Ob / Gyn coding and billing expert can dramatically improve the profitability of your practice. An aptly selected billing expert with expansive billing experience can improve the following aspects of your revenue cycle -

  • Facilitation of coding and billing automation for Ob / Gyn procedures
  • Updating billing software and system with recommended tests and CPT supporting diagnosesM
  • Monitoring of coding and billing procedure before filing of claims to reduce rejection rate
  • Following up on claims process and pre-authorization related procedural specifications of insurance carriers
  • Detecting underpayments by insurance carriers and filing for complete payment by the carrier for multiple and complicated procedures
  • Monitoring denied claims and reverting to insurance carriers with required documents or clarifications for rejected claims within specified turnaround time
  • Collection of accounts receivables from patients with complete focus on customer doubt resolution and payment processing for all surgical and non-surgical care procedures

With so much at stake for the Ob / Gyn practice, MedicalBillersandCoders.com can prove to be the ideal billing partner for you. They bring years of experience and technical expertise of its billers and coders’ team on board. Their updated coding software and panel of Ob / Gyn practitioners who facilitate the complete billing service can boost your revenue cycle management instantaneously. All the experts are on-shore and come with rich domain experience making your billing process seamless and effective every single time.


Category : Best Billing and Coding Practices