Obstetrics & Gynecology
We know the OB/GYN specialty, let us help you increase revenue to build your business.
Medical billing and coding for obstetrics and gynecology practices can be complex. Technically, the OB/GYN specialty is two separate medical specialties treating a broad range of conditions.
Practicing obstetricians and gynecologists can perform multiple procedures and treatments, some of which can generate an abundance of claims and involve multiple payors. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Etransmedia’s team of certified coders have the kind of experience necessary to ensure your OB/GYN practice will maintain consistent cash flow while increasing collection rates. All of our coders are certified either through the AAPC or AHIMA and uphold the ethics and standards of the profession. Additionally, our billers and coders understand how to reduce denials and A/R, improve revenue, and elevate back office bottlenecks with best practices.
What we know…
When an OB/GYN is delivering twins, with the first baby being a vaginal delivery but the second by cesarean, even though the OB/GYN performed the vaginal delivery first, that does not mean you should report this code first. You should report 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care) for the second baby and 59409-51 for the first. Why? You should bill the cesarean first because 59510 has higher RVUs (relative value units) than 59409. Most carriers typically consider the primary procedure to be the one with the higher RVU.
Practicing surgery providers perform multiple procedures and treatments, which will generate an abundance of claims, involve multiple payors and can result in a myriad of claims issues. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Here are some of the complications that are affecting OB/GYN revenue collection procedure:
Patient collection process
Lack of uniformity across pregnancy care
Rules around multiple procedures
Complexities of multiple diagnostic tests
On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We always try to stay on top of all the latest coding and billing updates for OB/GYN practices. Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date of what is happening in their practice so that any issues can be addressed quickly. The outcome of these processes and more is our clients have a streamlined revenue cycle with increased collection rates.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package