Specialty billing
OB/GYN Medical Billing and Global Maternity Care
Global maternity packages, antepartum splits and the gynecological surgery coding that sits alongside them.
The challenge
What makes OB/GYN billing different
Obstetric billing is unusual because the primary product is not an encounter, it is a nine-month package. The global maternity code bundles routine antepartum visits, delivery and postpartum care into a single claim submitted after delivery, which means a practice can carry the cost of a patient for the better part of a year before billing anything.
It also means every departure from the standard path — a transfer of care, a change of insurance mid-pregnancy, a delivery by a different practice, a high-risk course requiring extra visits — has to be unbundled and billed as components. Getting that wrong is one of the more expensive errors in the specialty.
Why us
Why OB/GYN practices work with us
Specialty billing is not a marketing label for us. Coders and A/R staff are assigned by specialty, so the person on your account reads notes like yours every day.
Get a free assessment- Global packages tracked from the first antepartum visit rather than reconstructed at delivery
- Care transfers and coverage changes unbundled into billable components correctly
- High-risk pregnancies billed for the additional documented work they genuinely involve
- Gynecological surgery coded to the approach and findings in the operative report
Scope of work
What we handle for OB/GYN practices
The work below is specific to this specialty, not a generic billing checklist with the name swapped out.
Global maternity packages
Package claims assembled from a tracked antepartum record, so no episode is billed from memory.
Antepartum and postpartum splits
Component billing when care is transferred, insurance changes or delivery occurs elsewhere.
Delivery coding
Vaginal, caesarean and after-caesarean delivery coding aligned to the delivery record.
Obstetric ultrasound
Ultrasound coded to the type performed and trimester, with the interpretive report supporting it.
High-risk obstetric care
Additional visits, fetal testing and maternal-fetal medicine work billed outside the global package.
Gynecological surgery
Surgical procedures coded to the documented approach, with global period rules applied correctly.
The Right Way difference
What we watch on OB/GYN claims
These are the details that separate a paid claim from an appealed one in OB/GYN. They are checked on every claim, not sampled.
- 01 Which antepartum visits fall inside the global package and which are separately reportable
- 02 Insurance changes mid-pregnancy, which usually force the package to be split across two payers
- 03 The number of antepartum visits actually delivered, which determines whether a package or components apply
- 04 Ultrasound frequency and medical necessity documentation, a recurring denial category
- 05 Global surgical periods and correct modifier use for unrelated care delivered within them
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Years running revenue cycles for physician practices
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Providers billed for across every specialty we serve
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First-pass clean claim rate
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Median days in accounts receivable
Questions
OB/GYN billing questions
What practices in this specialty ask us most often before making a change.
Ask us something elseThe global package usually has to be split, with each payer billed for the components of care delivered while their coverage was active. This is one of the most common places we find unbilled antepartum care when we take over an OB practice.
As component billing rather than a global package, since the practice did not provide the full course of care. The antepartum visits actually delivered, plus delivery and postpartum care, are billed as separate services.
Visits beyond the routine antepartum count contemplated by the global package can be separately reportable when the medical necessity is documented. High-risk pregnancies are frequently under-billed for exactly this reason.
How it works
Getting started takes about a month
The same four steps whichever specialty you are in. No system migration and no gap in your cash flow.
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01
Revenue assessment
We audit a sample of your claims, denials and aged A/R and show you what we found. Free, and yours to keep either way.
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02
Scope and agreement
A written scope covering exactly which services we run, what it costs and what we are accountable for.
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03
Access and onboarding
We set up inside your existing EHR and clearinghouse. Two to four weeks, run in parallel with your current process.
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04
Live and reporting
We take over submission and follow-up, and you get monthly reporting you can actually act on.
Free consultation
Let us look at your OB/GYN claims
Send us a sample and we will tell you specifically what is being coded, denied or under-paid — and what it is worth to fix. Free, and yours to keep.