OBGYN promises to be a holistic solution to the challenge of pregnancy bringing together obstetricians (specializing in pregnancy) and gynecologists (dealing with reproductive organs), thus ensuring a close coordination and synchrony between the two. But, thanks to this combination, some of the challenges OBGYN poses are unique.
Pregnancy is fraught with unforeseeable eventualities and gynecology is a specialty which deals with some of the most sensitive and varied nature of anatomies. And this collectively translates into multiple billing and coding challenges clinics providing OBGYN services are facing. When it comes to pregnancy, broken global is an example of how unforeseeable eventualities in the course of pregnancy can affect billing and coding.
Broken global happens when a pregnant patient procures a new insurance or moves to a new provider during the time of pregnancy. This becomes a challenge while preparing claims because every insurance provider has their own policies and procedures as well as different antepartum codes for single and multiple births.
So the medical biller has to have sound knowledge of the policies, procedures and codes of all insurance carriers so that in case of a broken global, he/she is able to apply them to bill services depending on under whose coverage – past or present carrier - a medical service (within an episode) was received by the pregnant patient.
Gynecology deals with a series of female anatomical afflictions, and pregnancy is just one of the areas. The medical biller needs to understand whether a test is related to pregnancy or not and bill appropriately. Another problem OBGYN faces is the multiple surgery syndrome. Doctors often perform multiple surgeries on the same patient at the same time and their details are amassed together. The biller has to apply different and appropriate code to each one of them.
These are most commonly faced problems in OBGYN and MBC has noticed that, if not handled properly, they undercut revenues substantially. For example, OBGYN, being complex, experiences a lot of denials and underpayments, hence if not pursued properly can result in a loss in collections of nearly 7 to 10%. Moreover these figures can multiply if you review the other reasons a clinic or hospital involved in OBGYN can lose revenue.
Medicalbillerandcoders.com Revenue Management Consulting services can help practices by assessing the in-house revenue management cycle; and ensuring sound coordination between the various components; hence facilitating smooth flow of medical data. MBC can also train staff to handle antepartum codes and challenges like broken global, denial management, billing enquiry etc.
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 OBGYN billing and coding activities, like - charge posting, review of medical details, denial management and revenue follow-up. MBC’s considerable experience helps it to handle challenges like antepartum codes, multiple surgery syndrome and so on. If you don’t think you need our entire suite of services, you can also pick and choose such parts of our services as exactly fit your OBGYN billing and coding needs and save costs.