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Gynecology

Unique Revenue Cycle Management for OB/GYN Medical Billing Services

Whether it is for a comprehensive gynecologist or an obstetrician, AltuMED has got you covered. Changing coding, documentation, and payer policies complicate reimbursement.

Maximize gynecology billing efficiency with our OB/GYN medical billing services, support, and analytics. Discover how AltuMED is driving maximized, timely reimbursement for top women’s health centers.

Our Billing Expertise Spans

Clinical Toxicology

Anatomic Pathology

Cancer Genomics

Molecular Diagnostics

Pharmacogenomics

Immunology

End-to-End Expertise in Gynecology Billing

We own the entire revenue cycle lifecycle:

  • Careful coding of OBGYN visits procedures using CPT guidelines
  • Rigorous editing to prevent rejections before submission
  • Rapid electronic transmission to all your contracted payers
  • Tracking and appealing any underpaid or denied claims
  • Posting explanations of benefits (EOBs) and payments
  • Detailed analytics reporting for complete visibility

Handle the process in-house for smoother cash flow and reduced admin burden.

Data Insights Drive Improved Reimbursement

Access real-time dashboards and detailed reporting for complete revenue cycle visibility with AltuMED. Key tracked metrics include:

  • Denial of root causes for informed appeal strategies
  • Reimbursement performance by CPT code and payer
  • Referral source productivity
  • Overall claim lifecycle status

Our analytics help enhance workflows, payer contracts, and bottom-line performance.

Challenges involved in OB/GYN Billing Services and Coding

OB/GYN medical billing can be particularly challenging due to several factors:

  • Pregnancy and Childbirth Care in ‘‘Bundle’’ Services: Some payers and insurers package the pregnancy and childbirth into one payment or into a single claim; the practitioner thus provides nine months of service only for him to be paid. All the claims are for a considerable amount; thus, it becomes very crucial that claims should not be rejected or denied.
  • Widely Varying Coverage: It should be noted that the treatment in the field of Obstetrics and Gynecology is one of the areas that as a rule an insurance company either restricts coverage of or does not cover at all. Customers mostly have complex reimbursement requirements of plans on what is and is not covered, which should be relayed to the patients.
  • Multiple Facilities: An OB-GYN practice must treat patients in the office as well as at the hospital and thus, coding for the two environments must be accurate. Being an OB-GYN billing company, our billers well understand in which scenario a particular procedure can be billed and also make sure that they document it appropriately.

Other Common Billing Errors

Some other standard billing and coding errors in OB/GYN include:

  • Failure to address separately billable services offered at the period under review across the world
  • Failure by people to appreciate that pregnancy is covered under an insurance plan as an amendment.
  • Failure in the documentation of policies and the overall service offered
  • This has been characterized by misconceptions as to what constitutes ‘medical necessity’ when it comes to the different grades of the ambulance services.
  • Lack of alphabetical categorization of modifiers for laparoscopic OB/GYN surgical procedures

Applying Best Practices for OB/GYN Medical Billing and Coding

To address these complexities, it's important to work with a specialized OB/GYN medical billing services and coding team that:

  • Is familiar with changing policy rules and ICD code changes file Reference 3, it is stated that.
  • Is aware of the fact of the given specialty’s sensitivity and can select proper codes from the operative reports.
  • Its model direction is built with an emphasis with efficient processes in the attempt to reduce the time which is necessary to generate accurate bills.
  • Work according to the rules of coding and standard protocols of coding while integrating modern technology.
  • On the other hand offers statistical analysis to minimize the denial rates and enhancement of the revenues.
A doctor and a patient are discussing report

Knowledge of the Shifting Payer Environment

It’s our specialized teams who make sure they’re up to date on the most recent changes in the payer policies relating to women’s health. This helps in the creation of correct claims to help avoid cases of underpayment and denial.

Gain the most reimbursement with our payers and compliance with documentation, coding, and submission processes.

Specialized Expertise in Gynecology Billing

AltuMED's gynecology billing experts have extensive experience with women's health centers nationwide. We manage the entire billing process, allowing you to prioritize patient care.

Discover how our services improve financial efficiency for practices nationwide. Contact us today!

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