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OB-GYN Billing: The Cross Road Between Over Coding and Perfect Coding


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OB-GYN billing and coding, on the face of it won't look like a tough undertaking to handle. However, with the increasing numbers of loss in reimbursement revenue things are not looking good for healthcare units. But the fact of the matter is, due to over coding and under coding, practices are losing lots of money and you don't even know it.

Bad medical billing and coding habits attributes to be one of the main reason physicians suffer through denied or delayed payments or reimbursement which is totally off the mark. A lot of practitioner fall victim to these habits without their knowledge, and it's not totally their fault.

Best Practices for Claims in OB-GYN Billing:

It's time your OB-GYN billers and coders break those bad habits and get your OB-GYN facility the profits it deserves!

1. Forgetting the Service Time on Claims Assessment and Management

There are several elements that make up your claims service time: the patient assessment and preparation (Pre-Time), performing the procedure (Intra-Time), and lastly, documentation, reporting and discharge (Post-Time). This habit basically eliminates the assessment and documentation done before and after the procedure respectively, both of which you have to be compensated for.

2. Calculating Intra-Time The Wrong Way

Aside from overlooking assessment and management before and after the actual procedure, some professionals also get their intra-time wrong, which leads to even more losses. Keep in in mind that intra-time includes all the one-on-one assessment and management time, from the moment you ask the patient how they have been since their last visit.

3. Utilizing the In And Out Time

Reporting In and Out time was a requirement once, (before 2007 to be exact). But, today only a few non-Medicare payers will still ask for it. The time requirement now that is mostly considered is the appointment time. So don't it's a better that the OB-GYN coders indicate in and out time for every payer and visit unless necessary, otherwise you'd just be welcoming auditors to scrutinize this against your scheduling program.

4. Count the Time of Each Intervention

In OB-GYN coding it is always logical to count and document time spent on each individual intervention, but this can just be troublesome in several ways:

Your systems can automatically classify these as 'TherEx' when they should be otherwise;

It causes the physicians to under coder or over code the assessment and management procedures that basically equates to loss of profit.

Giving exact number of minutes per intervention (when not necessary) opens you up again to more scrutiny during an audit.

Apart from these, painstakingly breaking up the exercise regimen to count and document minutes for each intervention is simply bothersome to the therapist. Wouldn't you agree?

It's not too late to break these bad habits and start some good ones, like partnering with a reliable OB-GYN billing company to help you maximize your practice profits. Interested in making that smart move? Get in touch with our OB-GYN billing and coding experts.

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