OB-GYN Medical Billing and Coding

Obstetrics and gynecology offices provide essential services for reproductive health before, during, and after pregnancies. Your focus needs to be on providing the best care possible for your patients and preparing them for the healthiest lives possible.

Outsourcing your OB-GYN practice medical billing, coding, and medical credentialing means your staff can focus on patient care while a specialist team works with the insurance companies to get payment for your services. Medical credentialing takes up a disproportionate amount of time, and offices of all sizes can benefit from outsourcing it, especially as your practice grows and you need your staff to focus on patients.

Billing and Coding Complexities

Since medical industry rules and regulations are complex, even doctors with specialized knowledge may struggle to keep up with all the changes. This is especially true because of the differences in coding in hospitals versus in individual physician clinics.

There are three main medical coding systems to be aware of: Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT), and International Classification of Diseases, 10th revision (ICD-10). HCPCS and CPT are very similar, but HCPCS is only used for Medicare insurance billing.

ICD-10 uses two subsets of codes to communicate both the procedures performed and the diagnoses or symptoms. In the U.S., ICD-10-PCS is used only in hospitals and contains procedures grouped differently than they are in CPT. Both hospitals and physicians use ICD-10-CM to communicate the reason for any procedures being performed.

Physicians in clinical settings use CPT codes to classify procedures instead of ICD-10. CPT codes sometimes include a bundle of related procedures, and some CPT codes may sometimes change or be subject to special rules that aren't obvious from the code description.

It takes a knowledgeable billing and coding specialist to sort through all the differences in procedures and codes. Having the correct CPT or ICD-10 codes is essential to ensuring your patients' care is reimbursed appropriately. Errors can lead to costly delays due to their care being denied by their insurance company.

Common Mistakes

OB-GYN billing becomes especially complicated immediately before, during, and after delivery. Certain prenatal and postnatal care is billable as part of the delivery itself, and it takes a knowledgeable OB-GYN coding specialist to sort through this. The proximity of the procedures to the delivery itself is a key component of this billing rule, but other factors affect the assigning of each billing code.

There is also a special set of billing codes for patients who deliver vaginally after previously having a cesarean section. There are slight differences in the amount of work required for these procedures that could entitle you to more reimbursements.

Mistakes and omissions in billing and coding can also result in a loss of important patient data for your practice and the insurance providers. This is especially important when determining maternal outcomes and could have long-term impacts on our understanding of reproductive healthcare.

Outsourcing Your Billing and Coding

Thanks to improvements in technology, it's easier than ever to outsource your billing and coding. Medical billing and coding specialists are well-versed in healthcare regulations and best practices for managing your information securely. This is especially important for OB-GYN medical billing and coding due to family planning and pregnancy's highly sensitive nature.

A company specializing in medical billing services will be more efficient because they can dedicate knowledgeable staff to handling your data full-time. When there's a lull in your practice's work, they simply move on to the next batch of coding. This increased efficiency reduces wasted working hours and downtime inside your office.

Outsourcing is a common and accepted practice for OB-GYN clinics. You can reduce the time you spend dealing with questions and corrections from insurers by letting an outsourced company get the job right the first time.

Medical Credentialing

Another time-consuming task that requires a specialized eye for technical details is medical credentialing. The paperwork required to keep your office in compliance with all applicable laws and regulations can take hours and must be completed clearly to avoid problems later.

This task results in more work when you're hiring a new staff member. Instead of assigning the work to an existing staff member, it's easier to outsource it. Giving even more work to someone already busy with other tasks is bad for morale.

Combining medical credentialing with your medical billing and coding outsourcing streamlines the process further. It's wise to trust the same experienced provider for both sets of services for greater efficiency and building an even more trusting relationship.

Focusing on Core Tasks

Sterilizing, stocking, scheduling, and maintaining the office take up a surprising amount of time each day. Because the amount of time these tasks take can vary depending on the number and types of appointments scheduled, your staff may not always have a predictable amount of time in their day to handle coding.

Even if you think you have your staff routines streamlined, there will always be fluctuations in demand and unexpected changes. For example, if a staff member suddenly leaves your team, you may be short-staffed and struggle to keep up with all the other necessary tasks on-site.

A medical billing and coding company keeps a team of specialists on hand to ensure the work always gets done. Since we don't have other tasks distracting us, we can focus on getting procedures and diagnoses coded and ready for you faster and more consistently.

Finding the Perfect Partner

Capital Billing Services is proud to put our knowledge to work for you. We offer medical credentialing, billing, and coding in addition to specialized consulting services. To give you more flexibility, we offer month-to-month services and don't require contracts. Contact us today to learn more about what we can do for you.