OB/GYN Billing

Within changes in Current Procedural Terminology (CPT) codes and the implementation of ICD-10, many OB/GYN practices have faced medical billing and coding difficulties that have increased claims denials and slowed the practice revenue cycle. OB/GYN billing and coding comes with unique challenges because of the abundant claims filing that comes with a practice that covers Obstetrics, Anesthesia for the procedure, Gynecology, and Family Planning. If your course deals with excessive claims denials hurting revenue, here’s a look at several strategies to avoid claims contradictions and improve revenue for your OB/GYN practice. ebix, Inc. is an expert in billing and coding for OB-GYN practices. Whether you’re starting a new medical practice or want to increase revenue for an existing rule, contact us today to find out how we can help you avoid common industry pitfalls and help you maximize revenue.

Avoid the Most Common Causes of OB/GYN Denials

It helps to be aware of some of the most common causes of OB/GYN denials to avoid them. A Physician’s Practice report noted that in the past, some of the unexpected top denials have included:

99214 – Outpatient doctor visit at a level 4

99000 – A specimen handling office-lab

81002 – Non-automated urinalysis without a scope

99213 – Outpatient doctor see at a level 3

36415 – Routine blood capture

There are several different reasons that these denials occur.

They often get a code 18 denial for a duplicate claim or service. At the same time, the insurance claims denied were previously in another procedure or service. These claims were refused because the system was separately paid. The payor doesn’t cover the charge, or it could be that the application has errors or lacks essential information required for reimbursement. Is it Time to Outsource OB/GYN Billing and Coding?

Hiring billing and coding specialists experienced in obstetrics and gynecology can be difficult, which is why many OB/GYN practices outsource. Even minor errors can end up causing claims denials, and with all the abundant claims filing that comes with OB/GYN billing and coding, it could be a good option for your practice to outsource your billing and coding. If your course is continuously trying to balance efficient medical care with an uninterrupted flow of reimbursements, outsourcing can give your practice the ability to focus on patient care. At the same time, someone else takes care of the intricacies of billing and coding for you.

Experienced OB/GYN Billing Services get you more.

It is essential to realize that the key to successful Revenue Cycle Management is understanding all your practice’s revenue sources. Hence, our team will help improve profitability by monitoring, measuring, and managing all aspects of your revenue cycle.

Indeed, the ebix team has excellent tools and experience. Hence, our Revenue Cycle Management solutions are in place to capture revenue from claims remittances, patients, and evidence-based data. Collecting from all these sources will help secure your practice’s healthcare payments and make it more profitable.

OB/GYN Billing Services for Your Practice

• Initial Credentialing is Free. Our expert staff reaches out to the carriers of your choice to obtain network status. Namely, accessible at a startup and a very reasonable fee per provider afterward.
• Fee Schedule Analysis. We enter the allowed amounts from the network contracts obtained to track and uncover any improper reimbursements. We will help research appropriate change levels.
• Workflow Consulting. Our management staff has over 100 years of combined experience. Therefore, we can advise you on the best practices to build a team and processes that ensure results.
• Carrier Contract Advice. Consequently, there are pitfalls to avoid in contracts and situations that may cause you to choose non-network status with challenging carriers. We have additional expert resources to bring help when necessary.
• Coding Expertise. The ebix team offers certified coding staff to “abstract” codes from provider documentation or review your code for accuracy and completeness. We offer Chart auditing services and provider/staff education. Additional revenue opportunities, compliance, and audit survival are the results of our efforts.
• Fees based on Results. We don’t get paid until we’ve obtained reimbursement for you.
• No Surprises. No additional charges for postage, claims, statements, or custom report/data analytics needs.
• Fast Claim Submission. Your billing will be submitted promptly after receipt. Don’t suffer from delays or write-offs from inappropriate submissions.
• Up to 10% Better Reimbursements.

Medical Coding Compliance

The ebix Chiropractic Billing Services team has a strong reputation as an expert in medical coding services. By and large, medical billing begins with accurate and complete documentation in the medical record. Hence, coding is how your intellectual services and labor translate into a code used to bill insurance and document the value of your service.

Perhaps most noteworthy are the ICD-10 codes. The ICD-10 is currently the cornerstone of classifying diseases, injuries, health encounters, and inpatient procedures in morbidity settings. Because of this, the ebix, Inc. team has honed medical coding skills and business processes to meet the needs of independent physicians.

Therefore, transforming a provider’s narrative or description of the disease, injury, and procedures into universal medical code numbers for the insurance claim is the fundamental purpose of medical coding. For this reason, our team of professional certified medical coders ensures higher reimbursement by properly aligning services with a medical diagnosis. Consequently, this doesn’t just assure proper payment. It will also minimize denials resulting from the incorrect association of diagnosis and procedure codes.

Data Analytics

Our financial reporting gives you the insight you need to address the root causes of charge issues, resolve process inefficiencies, improve coding compliance, and ensure the integrity of all claims. Office Managers and Administrators can quickly review performance and trends, drill down into the data to analyze root causes by reason, evaluate payer performance, and the financial impact of claim denials.

Examples of some of the financial reports we provide (above and beyond the regular month-end reporting that gives details about charges, collections, and your AR) include:

• Charge & Revenue Analysis – evaluate financial ratios versus MGMA benchmarks
• Coding analysis – identify potential under, over, and incorrect coding scenarios
• Procedure Analysis – analyze top CPT codes for cost-benefit analysis
• Payer Reimbursement Analysis – assess which payers consistently slow up payments through unnecessary denials and “lost” claims.
• Provider & Staff Productivity Analysis – evaluate provider and staff productivity based on the specific place of service, revenue, and RVUs
• AR Aging Analysis – velocity of payments per payor and CPT, respectively

Minimize Medical Claim Denials

Based on our experience working with physicians and healthcare organizations, we understand that the revenue cycle success starts at patient registration and continues throughout the claims cycle. Accuracy of patient demographics and financial information upfront results in reduced denials, fewer rejected claims and more occasional returned statements. Claim cleanliness is the critical component that stops the denial from origination, and the following parameters impact it:

• Patient registration data quality
• Prior-authorizations
• Non-covered services and medical necessity management
• Eligibility and benefits coverage
• Clinical documentation quality
• Coding
• Claim editing
• Payor rules & mandates