Introduction
OB/GYN practices are integral to women’s health, providing comprehensive care that ranges from pregnancy management to hormone therapy and preventive screenings. But behind the scenes, the billing for these services can be unexpectedly murky. Between maternity codes ranging from global to same-day, prophylactic, and diagnostic, among others, it is critical to code and document properly for billing purposes.
In this blog, we will explore how OB/GYN billing services in Plano operate, the distinct nature of women’s health billing, and why practices serving this population should consider working with professionals like MIU Billing.
Why OB/GYN Billing Is Unique
Women’s health includes everything from routine care to complex procedures, frequently offered during the same visit. This creates unique billing challenges:
- Billing for pre-vene and diagnostic procedures in the same visit.
- Managing worldwide billing of prenatal, delivery, and postpartum care
- Overseeing in-office procedures like colposcopies, biopsies, and IUD insertions
- Complying with payer-specific rules when it comes to frequency, documentation, and bundling
This complexity necessitates that OB/GYN billing be more than just a basic knowledge of medical billing — it requires specialization.
Common Services Included in OB/GYN Billing Services
Reputable OB-GYN billing companies like MIU Billing usually offer the following full-service revenue cycle support:
- Insurance verification for pregnancy benefits and procedural clearance
- Detailed listings of the codes for injuries and poisoning, as well as signs and symptoms
- Global maternity billing tracking from the first prenatal visit to the postpartum checkup
- Claim submission and follow-up
- Patient statements and collections
- Audit support and compliance reporting
Working with a team that has experience specifically with OB/GYN claims reduces the likelihood of claim denials and under-billing for practices.
Local and Why It Matters: Choosing a Local Billing Partner in Plano
When you use a Plano OB/GYN billing company, your practice enjoys:
- Knowledge of Texas Medicaid and regional commercial plans
- Faster response times and local support
- Collaboration with regional labs, hospitals, and diagnostic centers
- Well-versed in regional coding patterns and payer practices
Whether you’re a standalone OB/GYN unit or a component of a comprehensive women’s health system, it is imperative to work with someone who knows the local lay of the land, like MIU Billing.
Issues OB/GYN Billing Services Will Solve
Below are a few common challenges OB/GYN billing experts must deal with:
- Coding and reimbursement for both the Pap smear and pelvic exam
- Handling late prenatal care starts and out-of-network deliveries.
- Billing for proper anesthesia modifiers when performed in an outpatient setting
- Rebilling and appealing claims that have bundled rules incorrectly applied
A trained team is necessary so that providers will spend more time with their patients and less on paperwork.
Cost Structure: What to Expect
Typically, Plano OBGYN billing services cost the following:
- 4–9% fees (percentage of your total collection)
- Or a dollar amount per report used for the charge
- Or a flat fee per month for smaller or startup practices
Some “modules” (e.g., reporting, credentialing, collections, and so on) may be billed outside of the service, but most do not.
Ensure that you review packages and request detailed information on the services that each price includes.
Frequently Asked Questions
What is a global maternity billing?
It covers prenatal visits, delivery, and postpartum care — typically all rolled into one claim unless divided by payer rules.
Can I code a well-woman visit and treatment during a single visit?
Yes, as long as services have to be captured and coded independently with the corresponding modifier.
What would be the best practices in minimizing denial rates on OB/GYN billing?
Under-coding, clear documentation, and adequate billing personnel could assist in reducing the volume of denials and postponements you’re experiencing.
What should I consider when selecting a billing partner for an OB/GYN practice?
Seek out experience in women’s health, understanding of global billing, and a local touch, such as the one provided by MIU Billing.
Conclusion
OB/GYN billing is not just about getting paid; it’s about getting paid accurately and compliantly. Payers are constantly updating and creating new rules, as well as different combinations of services that make life as a specialist extremely difficult.
If you want an improved OB/GYN billing process, work with the experts who understand the needs of women’s health practices in Plano. A team you can count on, like MIU Billing, for local know-how and assuredness that you’re in good company when it comes to your revenue cycle, as your time is best served delivering care, not denying payment.
