OB-GYN Medical Billing Services

Generally routine antepartum visits, the delivery itself, and routine postpartum care, all billed as one charge after delivery. It assumes your practice provided all three parts. Problems unrelated to the pregnancy, additional monitoring for complications, and most ultrasounds sit outside it. Knowing what falls outside is where the recoverable revenue usually is.

Not with the global package, because you did not provide the full course of care. You bill the components you actually delivered: the antepartum visits you provided, the delivery, and postpartum care if you handled it. That means every visit needs to have been logged as it happened. Practices that only track the due date struggle to reconstruct this later.

The episode gets split between payers based on when care was provided under each plan. Neither payer will accept a global charge covering time it did not cover. You bill components to each, matched to their coverage dates. We re-verify benefits at plan year boundaries specifically because pregnancies so often cross one, and catching it early avoids a months-long cleanup.

Most likely a component split problem. If the scan was performed on hospital equipment and only interpreted by your physician, you bill the interpretation alone. Billing it globally collides with the facility's claim for the same date. Where the scan happens on your own equipment in your office, the global charge is correct. The setting decides, not the habit.

Yes, when the problem work is significant and separately documented. A new pelvic complaint evaluated during the annual exam is billable with the right modifier. Simply reviewing existing stable issues is not. The note needs its own assessment and plan for the problem. Without that separation, the additional line will not hold up under review.

Additional visits, monitoring, and detailed ultrasound beyond routine care can be billed separately from the package when medical necessity is documented. The record needs the specific condition making the pregnancy high risk, not just a general note that the patient is being watched closely. Practices frequently deliver this extra care and never charge for it.

Yes, and they need state-specific handling. Medicaid covers a large share of births, and rules on authorisation, presumptive eligibility, delivery payment, and filing deadlines vary considerably by state and by managed care plan. Filing windows are often shorter than commercial. We configure rules per state and per plan rather than treating Medicaid as a single payer.

As soon as postpartum care is complete and documented, since the package is billed after the fact. Waiting too long risks the filing deadline, which is measured from the delivery date by most payers. Because the episode has already run for months, the remaining window can be tighter than it looks. We flag delivered patients whose global claim has not yet been submitted.

Usually multiple-procedure reductions applied more aggressively than your contract allows. Several procedures performed in one operative session get automatic reductions from the payer's editor. When the percentage does not match your contract, the difference vanishes into the contractual adjustment. Line-level posting against loaded rates is what turns that into a recoverable underpayment.

Yes, and obstetric backlogs are worth working. Maternity claims often sit unresolved because reconstructing an episode takes effort a departing vendor has no reason to spend. We rebuild the visit history, determine whether global or component billing applies, and file what is still inside the window. Older gynecologic surgical denials are frequently recoverable too.