Top Obstetrics and Gynecology (OB/GYN) Billing Services
Our obgyn billing services streamline clinical operations, enhance the patient experience, and maximize your practice’s financial performance. We serve practices of all sizes across the USA. Reduce administrative costs by up to 50% with our expert revenue cycle management services!
- Credentialing and Payer Enrollment guidance for new OB/GYN practitioners
- Accurate CPT/ICD-10 coding for OB/GYN surgeries to prevent claim denials
- Complete OB/GYN billing, eligibility checks to postpartum AR follow-ups
- Rapid pre-authorizations for complex OB/GYN procedures and surgeries
- 100% compliance with Medicare, NCCI, and state Medicaid billing rules
What Key Challenges Make OB/GYN Medical Billing Services Essential?
Global Maternity Package Complexity:
OB/GYN billing must correctly apply global maternity packages, which bundle prenatal, delivery, and postpartum care using a single CPT code. Misapplication can cause claim denials and revenue loss.
CPT Code Updates for Tumor Excision:
CPT codes 49203 – 49205 are replaced by codes 49186 – 49190 that require providers to report the total size of all tumors or cysts removed. This change demands more precise documentation and coding expertise.
Insurance Verification and Prior Authorization:
The differences in insurance between Medicaid and private payers make OB/GYN billing complex. Other than that, procedures like hysterectomies and LEEPs require prior authorizations supported by proper clinical documentation.
All-in-one OB/GYN Medical Billing Services
Obstetrics and Gynecology practices face increasing pressure to manage billing efficiently. We offer the following OB/GYN billing services to tackle these challenges:
- OB/GYN Credentialing
- Appointment Scheduling
- Patient Eligibility Verification
- OB/GYN Surgeries Pre-Authorization
- OB/GYN Medical Coding (ICD-10, CPT, HCPCS)
- E/M Code Audits and Modifier Accuracy Checks
- Charge Entry & Electronic Claims Submission
- OB/GYN Clearinghouse Transmission
- Billing Appeal Creation
- Denial Management
- A/R Recovery and Payment Posting
Expert OB/GYN Credentialing Services for Smooth Provider Enrollment
Credentialing is a critical first step for OB/GYN practitioners to begin billing insurance and receiving reimbursements. However, this process typically takes 60 to 90 days and requires over 20 hours of administrative work per provider.
BilRex provides this essential service complimentary as part of our RCM package, while other companies charge between $200 to $800 per provider. We simplify credentialing for OB/GYN providers by managing the process from start to finish. To help you avoid revenue losses, our OB/GYN medical billing experts ensure accurate CAQH profile setup and continuous tracking with payers.
Proven Expertise in
50+ EHR/EMR/PMS
WebPT
Tebra
RXNT
PracticeEHR
PracticeFusion
NextGen
Kareo
Epic
EclinicalWorks
DrChrono
CureMD
ColaboratesMD
CentralReach
CareCloud
AthenaHealth
AdvanceMD
Get The Answers You Need
Frequently Asked Questions (FAQs)
Get answers to the most common questions that Obstetrics and Gynecology (OB/GYN) practices ask about our billing services.
OB/GYN billing covers bundled maternity packages, surgical procedures, and preventive women’s health services. Billing for prenatal, delivery, and postpartum care falls under global maternity codes (59400 to 59622), which have strict payer rules. Errors, such as including unrelated office visits in the global package or incorrect use of modifiers (-24 for unrelated visits or -25 for same-day services), are common causes of denials. Specialized knowledge is essential to code these correctly and protect revenue.
We have certified coders who specialize in OB/GYN and complete regular training on CPT, ICD-10, and payer updates. We track guidelines from CMS, ACOG, and commercial payers and use compliance software to stay current on code changes. This ensures correct billing for services like high-risk pregnancies, infertility procedures, and gynecologic surgeries.
Yes. We use HIPAA-compliant billing platforms with secure, encrypted data exchange. Claims are automatically checked against payer-specific rules before submission, which reduces errors and keeps patient health information secure.
Yes. We give practices clear, real-time reporting on claim submissions, payments, denials, and key performance indicators like collection rates and turnaround time. This helps OB/GYN practices track revenue trends and quickly spot any issues that need attention.
Outsourcing OB GYN medical billing and coding services saves your practice valuable time by managing the complexities of maternity packages, bundled procedures, and payer-specific rules. Our OBGYN clients experience fewer claim denials, faster payments, and reduced accounts receivable days.
We review and resolve denials promptly, typically within 24–48 hours. Our team ensures bundled maternity services are coded properly and unrelated services are billed separately using the correct modifiers. We also track denial patterns to ensure that future claims are less likely to be rejected.
Yes. We handle new provider credentialing, re-credentialing, and payer contract updates, including Medicaid maternity program enrollment. This prevents delays in getting paid when new providers join or existing providers expand services.
We specialize in OB/GYN care, with coders trained in specialty-specific rules and dedicated account managers for each client. Our expertise reduces bundling errors, improves claim acceptance rates, and provides practices with clear financial visibility, resulting in faster payments and enhanced operational efficiency.
