Are Maternity Claims Increasing Payer Audit Exposure?

Yes, maternity claims are increasing payer audit exposure—with OBGYN practices collecting $1M–$5M+ monthly experiencing 42–58% audit rates on global obstetric billing when commercial payers scrutinize CPT 59400 claims for unbundling violations, delivery complications underdocumented creating medical necessity denials, and VBAC coding errors triggering systematic recoupment demands of $1.2M–$3.8M annually, directly suppressing EBITDA and net realized […]

How Global Maternity Bundle Exceptions Are Costing OBGYN Practices $1.2M-$3.6M

Global Maternity Bundle Exceptions Costing OBGYN $1.2M–$3.6M

Global maternity bundle exceptions cost OBGYN practices collecting $1M-$5M per month between $100,000 and $300,000 in monthly revenue totaling $1.2M-$3.6M over 12 months because the four categories of services that fall outside the global obstetric package high-risk pregnancy complications, transfer-of-care scenarios, separately billable diagnostic procedures, and ancillary services excluded by payer-specific contract terms are systematically […]

Are Preventive GYN Exams Facing High Rejection Rates From Payers?

Yes, preventive GYN exams are facing high rejection rates from payers—with OBGYN practices collecting $1M–$5M+ monthly experiencing 32–48% denial rates on routine pelvic examinations and annual Pap tests because recent USPSTF guidelines classify screening pelvic exams in asymptomatic women as having insufficient evidence for benefit, prompting commercial insurers to deny claims as “not medically necessary” […]

How Staffing Shortages Are Impacting OB Coding Accuracy

Staffing shortages are impacting OB coding accuracy by creating $1.2M–$3.8M annual revenue leakage for OBGYN practices collecting $1M–$5M+ monthly—because the 30% certified medical coder shortage combined with 31% of healthcare staff considering leaving forces existing coders to process 40–60% higher claim volumes under burnout conditions, resulting in systematic undercoding errors ($1,582 per provider weekly in […]

Why 2026 Is a Turning Point for Women’s Health Reimbursement

2026 is a turning point for women’s health reimbursement because three simultaneous policy shifts—the 2026 Medicare Physician Fee Schedule Efficiency Adjustment, HRSA’s expanded preventive care mandates, and 46-state permanent Medicaid postpartum extensions—are restructuring financial performance metrics for OB-GYN and women’s health practices, creating both significant revenue risk and recoverable opportunity for practices collecting $1M to […]

7 OB-Gyn Billing Errors That Delay Reimbursements by 30–45 Days

7 OB-Gyn Billing Errors That Delay Reimbursements 1. Unbundling services already included in the global package2. Forgetting Modifier 25 when billing E/M services with procedures3. Missing that 7th character for ICD-10 trimester specificity4. Sequencing pregnancy codes wrong (O-codes need to be primary)5. Skipping prior authorization for ultrasounds and NIPT6. Incomplete documentation for extra antepartum visits7. […]

OBGYN Credentialing in Weeks, Not Months: Get 6 Payers for the Price of 5

OBGYN credentialing shouldn’t take six months of your valuable time while patients with specific insurance plans walk out your door. Yet for most OB/GYN practices, the credentialing nightmare is all too real—endless paperwork, unresponsive insurance representatives, and revenue hemorrhaging while you wait for approval. As an OBGYN, you face unique credentialing challenges. Beyond standard medical […]

Your OBGYN Practice is Bleeding $10,000+ Monthly—Here’s How to Stop It (Risk-Free)

What if I told you that while you’re delivering babies and providing life-changing women’s health care, someone else is killing your revenue? You didn’t complete your OBGYN residency to become a billing expert. Yet here you are, drowning in rejected maternity claims, complex coding requirements, and revenue that’s bleeding out faster than you can say […]

OB-GYN Medical Billing Outsourcing in Texas: Cut Denials, Increase Revenue

Transform Your Practice’s Financial Health with Expert Medical Billing Solutions Texas OB-GYN practices face unprecedented challenges in medical billing—from complex coding requirements to escalating claim denial rates. Studies show that claim denial rates in the OB/GYN specialty can reach as high as 22.42%, significantly impacting revenue cycles and practice profitability. Outsourcing your medical billing to […]

OBGYN Billing in Pennsylvania: IUD and Injectable Billing That Pays

OBGYN billing in Pennsylvania presents unique challenges, particularly when managing intrauterine devices (IUDs) and injectable contraceptives. These procedures require precise coding, proper documentation, and strategic billing approaches to ensure maximum reimbursement. Medical Billers and Coders (MBC) has helped OBGYN practices across Pennsylvania reduce their accounts receivable by up to 30% through specialized expertise in OBGYN […]

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