Pregnancy billing includes bundled services covering prenatal visits, delivery, and postpartum care. Incorrect billing timelines or missing documentation often result in underpayments or denials.
OB/GYN claims commonly face denials related to medical necessity, modifier usage, authorization issues, and incomplete documentation. Even preventive visits may be denied if coded incorrectly.
Procedures like hysterectomies, laparoscopies, colposcopies, and C-sections require precise CPT and ICD-10 coding. Small coding mistakes can lead to major reimbursement losses.
Payer rules for maternity care, ultrasounds, preventive screenings, and contraceptive services frequently change. Keeping up with these updates takes time and expertise.
Unresolved denials and unpaid claims create aging accounts receivable that impact cash flow and financial stability.
Many OB/GYN procedures and imaging services require prior authorization. Missing approvals before treatment can result in claim rejections after services are already performed.
We assign accurate CPT, ICD-10, and HCPCS codes for obstetrics, gynecology, surgeries, preventive visits, ultrasounds, and maternity care. Our coding process helps maximize reimbursement while reducing compliance risks.
We manage prenatal, delivery, and postpartum billing according to payer-specific global package rules. This ensures proper reimbursement throughout the full maternity care cycle.
Clean claims are submitted quickly with multiple accuracy checks before transmission. If claims are denied, we investigate, correct issues, and aggressively follow up for payment recovery.
We verify patient eligibility, confirm maternity coverage, and secure prior authorizations before services are performed to prevent avoidable denials.
Our team posts payments accurately, identifies underpayments, and follows up on aging claims to improve collections and reduce AR days.
We generate patient statements, manage balances, and assist with payment collections while maintaining a professional patient experience.
We understand the complexities of maternity billing, preventive services, surgeries, and payer guidelines unique to women’s healthcare.
Our clean claim process and coding accuracy help reduce denials and speed up reimbursements.
We work with major OB/GYN practice management and EHR platforms without disrupting your workflow.
Track collections, payer performance, denial trends, and revenue growth with transparent reporting.
Your patient and financial data stay fully protected with secure workflows and compliance-focused operations.
You receive personalized support from a team that understands your specialty and billing needs.
Our team helps align documentation with coding requirements to reduce payer scrutiny and denials.
Claims are processed quickly and accurately to reduce delays and improve payment turnaround times.
Denied or underpaid claims are tracked, corrected, and appealed to recover every possible dollar.
Consistent follow-ups and AR management reduce outstanding balances and improve monthly collections.
Detailed reporting helps identify revenue leaks, payer issues, and growth opportunities.
Your staff spends less time on billing issues and more time supporting patients and providers.
| Metric | RCMXpert Baseline | Industry Average for Ob/Gyn |
|---|---|---|
| First-pass acceptance rate | 91% | 73% |
| Days in A/R | 32 | 58 |
| Denial rate | 9% | 21% |
| Implant capture rate | 98% | 76% |
| Modifier 73/74 accuracy | 99% | 68% |
| Appeal success rate | 80% | 35% |
We are not just medical billing providers; we are your dedicated partners in healthcare management services. Contact us to discover tailored solutions that transcend industry standards. Whether you’re a solo practitioner or a large healthcare facility, our expertise is designed to optimize your financial performance.
4323 COLDEN ST APT 10I FLUSHING NY
740-766-6083
info@rcmxpert.com
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