Home » OBGYN Medical Billing for smooth Practices Workflow

OBGYN Medical Billing for smooth Practices Workflow

by Uneeb Khan

OBGYN medical billing is complex. Tens of thousands of OB/GYNs in the United States must negotiate the difficulties of medical billing every year. In 2010, general OBGYNs accounted for 5% of all physicians in the United States. There were over 30,000 of them working across the country, mostly in major cities. OBGYN billing can be complex, particularly for private practice physicians, independent providers, and clinics.

Medical practices linked to hospitals and hospital networks have billing departments and coding specialists on-site, meaning that OBGYN practitioners in hospital networks have less to worry about. Unfortunately, since they lack that assistance, private practice clinicians spend much more of their time worrying about OBGYN medical billing concerns.

The complexity of medical billing affects all OBGYNs. Still, independent clinics, private practitioners, and small clinics that lack the backing of an extensive hospital network are set up to have a more difficult time responding to changes in medical billing standards, legislation, and software.

Many small OBGYN clinics prefer to outsource their medical billing. It relieves the stress of conducting medical billing tasks on your own and provides a crucial safety net. Choosing the best medical billing company to handle your practice’s particular billing needs is a critical choice that, when done carefully, may reduce stress and boost your practice’s overall profitability.

Before we get into the numerous ways a medical billing service like NEO MD Medical Billing & Consulting may help your OBGYN practice, let’s look at the particular issues of medical billing in the context of obstetric and gynecological treatment.

OBGYN Medical Billing
OBGYN Medical Billing

Healthcare Law Changes

The healthcare system in the United States is in transition. Although the Patient Protection and Affordable Care Act (ACA) was enacted into law in 2010, several provisions were not immediately implemented. Many of the ACA’s regulations were not supposed to go into effect until 2014, while others were supposed to go into force by 2020, which caused some uncertainty. Because of widespread opposition to the legislation, several portions of it have been blocked or replaced by other programs. The present government has also ordered some adjustments by executive order. There are certain rules that medical billing professionals expect to persist regardless of the political climate, and there are other parts of the job that are entirely up for grabs.

Benefits OF Partnering with NEO MD OBGYN Medical Billing Services

The advantage of partnering with us is that we are a one-stop shop medical billing company that performs the following:

  • Revenue Cycle Management: We gather all patient data to process insurance claims and calculate copays and unpaid bill balances.
  • Follow-up services for collecting accounts receivable
  • Leverage real-time performance analytics
  • Find and plug revenue leaks
  • MACRA and MIPS reporting
  • Services for clinical documentation to raise the standard of EMRs and other documents
  • Our billing team assists you in enrolling and receiving credentialing for essential services like Medicare, Medicaid, CAQH registration, and EFT/ERA enrollment.
  • CPC, CPMSM, and CPCS certified

Advocates for various healthcare methods are active at the state and federal levels, which means that OBGYN medical billing experts must keep up to date on what is necessary, what is prohibited, and what is in accordance with the most recent local, state, and federal legislation.

Here are a few instances of how the ACA has affected medical billing:

  • The number of individuals who have insurance has increased, which indicates that there has been an increase in claims and visits to medical providers.
  • Insurance policies now cover many OBGYN appointments as preventative care, with no patient payment. This includes yearly physicals, preconception care, family planning counseling, HIV screenings, screening for intimate partner violence, and screening for other diseases such as HPV and cervical cancer.
  • ICD-10 codes are now mandatory for all medical coding, including OB/GYN.

Significant understanding of Medicare, Medicaid, public and private insurance plans

Medical billers must be knowledgeable with the complexities of various health insurance companies and plan types. Consider the following issues and subjects that OBGYN medical billing professionals should be able to include into their practice:

  • Patients whose provider is in their network
  • All available public and private healthcare plan that patients may be using to cover costs
  • Payment plan options
  • Global billing vs technical billing (which is especially important for OB/GYN providers)
  • Patients whose provider is out of their network
  • Avoiding duplicate claims or procedures that are covered by an already existing code
  • Discount policy for cash payments

One key service that OB/GYN offices should give is someone who can explain (in simple words) how billing will work for pregnancy, taking into account considerations such as whether or not prenatal treatment and delivery will occur in the same calendar year.

The Importance of Avoiding Incorrect OBGYN Medical Billing and Coding Errors

Improper coding has been one of the leading causes of insurers refusing to pay claims since the advent of ICD-10 coding. This is something that many patients are aware of, with some even requesting coding information during their appointment. ICD-10 codes are used in conjunction with Current Procedural Terminology (CPT) codes. CPT covers services delivered, whereas ICD-10 addresses diagnosis.

Avoiding coding faults is one of the most important jobs of a medical billing expert. Understanding the differences between codes According to CPT statistics, the most common coding errors for OBGYN Medical Billing include:

  • 36415: Routine blood capture
  • 99213: Outpatient doctor visit, level 3
  • 81002: Urinalysis non-automated without scope
  • 99214: Outpatient doctor visit, level 4
  • 99000: Specimen handling office-lab

And the frequent explanations for these denials are:

  • 16: Claim lacks information or has errors
  • 96: non-covered charge(s)
  • 18: Duplicate claim/service
  • 234: Procedure not paid separately
  • 97: Payment for another procedure already included the benefit of service

Avoiding these mistakes requires strong attention to detail, but also specialized training for the person or people who are answerable for effecting all of the CPT and ICD-10 codes for the practice. Inaccurate, insufficient coding, or a lack of detailed information in the coding process can lead to insurers rejecting payment and patients being unable to pay.

How does NEO MD Medical Billing support its partnered OBGYN Medical Billing providers?

NEO MD partners have access to a variety of Cardiology Billing solutions. For OBGYN Billing, we provide HIPAA-compliant coding and billing. To give excellent services to our consumers, we employ cutting-edge equipment and technology. NEO MD is proud of its Cardiology services since they maximize claim returns while decreasing the chance of human error. Profits are higher for programmers, billing specialists, specialized software, and trained labor than for the market.

When compared to other revenue cycle management companies, NEO MD’s OBGYN Medical Billing services are regarded among the finest in the US. NEO MD also provides medical billing services for small practices, medium-sized and big clinics. Our revenue cycle management services also offer specialized billing services to the physicians in all 50 states. Moreover, the medical practices may search for the best Medical Billing company near me to get our services.

OBGYN Medical Billing
OBGYN Medical Billing

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