Obstetrics and Gynecology (OBGYN) Billing Services
Maximizing Reimbursements for Obstetrics and Gynecology Providers
Expert billing support addressing specific challenges faced by OBGYN providers, including complex coding requirements, intricate claim submissions, and nuanced reimbursement processes.
Why Is Successful Billing Delivery Such A Challenge to OBGYN Organizations?
Managing global billing for maternity care, including antepartum and postpartum visits, requires meticulous attention to detail. Additionally, navigating the complexities of billing for fertility treatments, such as in vitro fertilization (IVF) and associated diagnostic tests, adds another layer of intricacy.
Furthermore, handling OBGYN billing involves adeptly managing claims for various gynecological procedures, ranging from routine preventive services like Pap smears and mammograms to intricate surgeries such as hysterectomies or laparoscopic procedures. Each procedure comes with its own coding intricacies, demanding a keen eye for detail to ensure accurate billing and optimal reimbursement.
And then there are additional factors to consider, such as varying coverage amongst insurers and providing care across multiple healthcare facilities.
Improve Reimbursements and Fast-Track Your Financial Growth
After 12+ years of providing obgyn billing services to OB GYN Practitioners nationwide, we’ve become experts with the distinct medical coding and OB GYN billing practices required for successful revenue management. Neolytix’s dedicated team of well-trained experts specializes in detecting the obstacles that prevent your organization from achieving its growth goals.
AR Reduction
The best cure is prevention. That’s why our teams put the emphasis on reduction in the front head before claims submission. With a meticulous focus on perfection, denials & AR are reduced.
Revenue Leak Detection
Through a meticulous review of your billing processes, we are able to identify and address potential sources of revenue loss and plug the holes, once and for all.
Expertise in Appeals
Our expertise and knowledge of the processes act as protective measures against denials. We methodically tackle concerns to guarantee you obtain the highest possible reimbursement.
Ongoing Compliance & Coding Audits
We conduct routine compliance audits to identify potential issues or areas of improvement. This proactive approach can help catch problems before they lead to denials or legal issues.
Credentialing and Network Management
Help organizations maintain proper credentialing for their providers and ensure that they are in-network with relevant insurance companies. This can prevent denials due to provider issues.
Prior Authorization
Management
Assist in managing prior authorizations to ensure that required authorizations are obtained before services are rendered.
Our Supporting Pillars Of Obstetrics and
Gynecology (OBGYN) Billing Excellence
With over 12 years of invaluable experience in obstetrics and gynecology billing services field, Neolytix brings a wealth of expertise to the table, ensuring that our dedicated teams adeptly apply the best ob-gyn billing practices to optimize your revenue cycle management. Our commitment to excellence is reflected in the following core strategies:
Continuous Training & Accreditation:
Our coders, certified by AAPC, utilize their expertise to accurately assign CPT, HCPCS, and ICD-10-CM codes, and undergo constant training of code and best practice updates to ensure both compliance and precise billing.
Coding Audits & Education :
Neolytix performs pre-billing audits to identify and rectify potential billing errors before submission, minimizing claim rejections and delays. We also offer obgyn coding education training to upskill your in-office teams.
Cross-Network Experience:
We have in-depth process and compliance knowledge of all the major commercial carriers, including United Health, Aetna, Humana, Blue Cross Group, WellPoint, etc. (Contract renegotiations available upon request)
Keeping Up with Compliance:
Neolytix stays vigilant in adhering to evolving healthcare regulations, ensuring that your OBGYN billing remains in compliance with industry standards.
The Coding Culprits Affecting Your Cashflow
Obgyn billing and coding precision play a critical factor in ensuring optimal reimbursement. Within the spectrums of Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes lie certain culprits that, when overlooked, have the potential to significantly impact your cashflow.
Common CPT Codes
59400 (Global OB Care)
Clearly document antepartum care, delivery, and postpartum care, emphasizing the comprehensive nature of global obstetric care.
59425 (Antepartum care only)
Ensure documentation supports billing for antepartum care only, clearly distinguishing it from global maternity care.
59510 (Routine obstetric care including antepartum care, vaginal delivery, and postpartum care)
Document the routine obstetric care provided, specifying antepartum care, the details of the vaginal delivery, and postpartum care.
76805 (Ultrasound, pregnant uterus, real-time with image documentation, fetal and maternal evaluation, after the first trimester)
Clearly state the medical necessity for the ultrasound, including the gestational age, fetal and maternal evaluation, and any abnormalities identified.
Common ICD 10 Codes
Z33.1 (Pregnant state, incidental)
Document the reason for the encounter other than pregnancy, emphasizing that pregnancy is incidental to the visit.
Z3A.xx (Weeks of gestation)
Specify the gestational age, supporting accurate coding based on the number of completed weeks of gestation.
O09.211 (Supervision of high-risk pregnancy, first trimester)
Clearly document the conditions or factors that classify the pregnancy as high-risk during the first trimester.
O34.21 (Maternal care for other abnormalities of pelvic organs, first trimester)
Provide detailed documentation of maternal care related to specific abnormalities of pelvic organs during the first trimester.
Billing Proficiency Across Obstetrics and Gynecology (OBGYN) Spectrum
Multi-Specialty Experience
Our billing teams, running the obgyn medical billing services, have experience across the OB GYN specialty board, which includes doing billing and revenue cycle management for:
- Gynecological Uro-gynecology and Pelvic Reconstructive Surgery
- Reproductive Endocrinology and Infertility
- Maternal-Fetal Medicine
- Advanced Laparoscopic Surgery
- Pediatric and Adolescent Gynecology
- Menopausal and Geriatric Gynecology
- Family Planning
More Reasons to Choose Neolytix OB GYN Billing Services
Neolytix provides services around the clock to OBGYN organizations nationwide. Each team member in our billing team receives ongoing training and is upskilled in harnessing new technology and remaining compliant. Continuous training happens behind the scenes at no cost to your organization and won’t affect your medical billing, coding, and collections operations.
Constant availability to speed up billing processes and to ensure continuous support for your healthcare organization.
We provide organizations with analytics and reporting tools to monitor key performance indicators related to billing and denials, allowing for data-driven decision-making.
Improved accuracy in claims submissions and reduced billing errors & monitoring of coding changes, and amendments.
Free up your time by outsourcing medical billing services and administrative tasks to focus more on patient care and big-picture tasks for your healthcare organization.
Benefit from our flexible and customized pricing options, designed to ensure cost-effectiveness and financial efficiency for your OB GYN practice or group.
Partner with Neolytix Today
Don’t let billing challenges hold you back. Partner with us and streamline your practice’s financial operations
100% Probability of Revenue Improvement
99% Claims Acceptance Rate
12+ Years of Experience
HIPAA Complaince
CUSTOMER TESTIMONIALS
Listen to what our clients have to say
Sarah CharmchiI chose Neolytix for credentialing our practice. The team was knowledgeable, responsive and kind and supported us through the process. I would certainly recommend their services.Sue RobbinsNeolytix has helped so much with our outstanding A/R. They are always so very willing to help and complete the task in a timely manner.TobyWe transitioned to Neolytix a while back, having come from a billing company we were less than thrilled about. The people here have been very responsive to our needs and requests, and adapt quickly to whatever curve balls our practice throws them. They bring a wealth of knowledge to the table, and take the attitude that our success is their success.Sandy MI was a new office manager for a private practice when I hired Neolytix for credentialing assistance. Eden has been very thorough and helpful every step of the way. insurance credentialing can be so overwhelming at times, that having this task off my plate has given me a peace of mind. I know she is handling everything. Always quick to respond to questions or concerns.Cheryl LambertNeolytix is the most professional and hard working billing company I have ever been partners with . I call them a partner because they truly are. Neolytix makes sure what they bill is accurate. Their knowledge of physician billing is outstanding. The entire team takes control and does what is necessary to make sure you get paid.
Start Your OBGYN Organization's Revenue Improvement Journey Today!
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Essential FAQs for OBGYN Practices
In the field of obstetrics and gynecology, accurate coding is crucial for ensuring proper reimbursements. The specific billing codes used by an obgyn billing company vary depending on the type of service provided.
For example, routine obstetric care often uses CPT code 59400, which covers antepartum care, delivery, and postpartum care. However, different procedures and services will require unique codes, making it essential to work with billing experts for obgyn to avoid costly errors.
Outsourced medical billing involves partnering with a specialized obgyn billing company that handles the entire billing process on your behalf. This includes everything from patient data entry, claim submissions, and follow-up on denials, to revenue cycle management and compliance audits. By leveraging the expertise an ob gyn medical billing and coding team, healthcare providers can focus more on patient care while ensuring their financial operations run smoothly. Outsourcing obgyn medical billing services not only enhances accuracy but also accelerates reimbursements and reduces administrative burdens.
The CPT code for a typical OB visit can vary based on the stage of pregnancy and the specific services rendered. Common codes include 99213 for a standard office visit and 59425 for antepartum care only. It's important to use the correct code to reflect the nature of the visit accurately.
One way to look at it is that by partnering with a knowledgeable obgyn billing services provider you ensure that these codes are applied correctly, reducing the risk of claim denials and ensuring proper reimbursement and by leveraging obstetrics and gynecology billing services, these services help maintain compliance and optimize revenue, thus creating a complete protection system.
There isn’t a single CPT code that represents pregnancy itself; instead, specific codes are used to represent different aspects of pregnancy care. For example, CPT code 76805 is used for an ultrasound of a pregnant uterus in the second trimester. OB GYN medical coding experts play a crucial role in ensuring that all pregnancy-related services are accurately billed, which maximizes reimbursements through precise ob gyn billing services.
Yes, the initial OB visit can be billed separately using specific codes. For instance, if the visit includes a comprehensive examination and history, it may be billed using a code such as 99204 or 99205, depending on the level of service provided. Accurate documentation and coding are essential for this process, making it beneficial to engage with a billing company for obgyn that specializes in gynecology billing services. They ensure that every visit is billed appropriately, including the initial OB visit, contributing to the financial health of your practice.
OB, or obstetrics, in medical billing refers to the specialized billing practices associated with pregnancy, childbirth, and postpartum care. This area requires specific ob gyn medical billing expertise due to the complexity of global billing, where services are bundled into a single claim. Partnering with a dedicated ob gyn billing company ensures that all aspects of obstetrics care are billed accurately, from prenatal visits to delivery and postpartum care, maximizing reimbursements and minimizing errors.
When billing for a pap smear only, it’s essential to use the correct CPT code, typically 88142 for a routine pap smear. Working with a gynecology medical billing services provider helps streamline this process, ensuring that the pap smear is billed correctly as a standalone procedure, which can reduce claim rejections and improve cash flow. The key is to ensure that the code accurately reflects the service provided, without bundling it with other gynecological services.
OB global billing refers to a billing practice where all prenatal visits, labor, delivery, and postpartum care are bundled into a single comprehensive claim. This method is common in obstetrics medical billing as it simplifies the billing process and can lead to more predictable reimbursement outcomes. However, it requires meticulous obgyn billing and coding to ensure that all services are correctly captured under the global billing code. By partnering with a specialized ob gyn medical billing company, you can ensure that your practice’s global billing is both accurate and efficient.
The coding for a gynecological exam typically involves CPT codes such as 99394-99397, depending on the patient’s age and whether the exam is preventive. These codes must be applied correctly to ensure that the exam is billed appropriately and reimbursed fully. Accurate ob gyn coding is crucial in this context, and engaging with a professional obgyn coding service ensures that your practice adheres to all coding guidelines, minimizing the risk of claim denials.
One of the most common CPT codes used in billing obgyn is 59400, which covers global obstetric care, including antepartum, delivery, and postpartum care. This code is frequently used due to the comprehensive nature of obstetric services.
However, other codes like 99213 (office visit) and 59510 (routine obstetric care including cesarean delivery) are also prevalent. Partnering with an experienced ob gyn billing company can help ensure that these and other CPT codes are used correctly, leading to optimized revenue and reduced administrative burden.