Typically, hospital and professional coding begin when an obstetrician-gynecologist records
information on patient services. When that information is sent out as a charge capture, it is
assigned a OB/GYN billing code. It isn’t easy to navigate this process, especially since everything from
hospital room to various processes and tests must be billed for reimbursement. This
necessitates highly qualified professionals with experience securing revenue opportunities
while protecting healthcare organizations from compliance risk and financial penalties.
Challenges with OB/GYN Billing Processes:
As the revenue cycle progresses, information is passed from one department to the next.
Hospitals risk losing revenue integrity if any miscommunication or details are included.
Insurance companies already under financial pressure deny a significant percentage of claims
based on mismatched procedures and ICD codes.
Many coding errors occur because coding professionals need more detailed physician
documentation or rushed intake information. These professionals sometimes need to be made
aware of coding updates. For example, they may need to be mindful that two procedures are
linked, so they bill each separately. This may result in each claim being denied for unbundling.
Leveraging Technology as a Solution:
When healthcare organizations invest in technology, hospital, and professional coding, experts
can enhance quality and ensure accurate reimbursement. Consider the EHR system, which
brought a “paper-heavy process into the digital age.” Its importance in healthcare is
undeniable, especially given OB/GYN coding professionals’ role in the revenue cycle. However,
it is far from the only advantage a technology can leverage to these professionals to achieve
and maintain long-term quality, compliance, and reimbursement results.
Let’s look at how leveraging technology can influence OB/GYN billing and coding processes in
ensuring your healthcare organization’s optimal financial performance:
● Lowering Accounts Receivable Days
Declining patient volumes are just one of the sources of a hospital’s revenue problems. A/R
days creeping upward can put additional strain on already-stressed accounting departments.
Modern RCM technology accelerates OB/GYN billing services that take longer to complete
manually and automates many of the follow-up steps required for some claims to be paid.
Keeping A/R days within acceptable limits will assist you in maintaining control of your cash
flow in a challenging financial environment. Cash on hand is critical to maintaining stability and flexibility to make the necessary investments, such as offering competitive wages in a tight
● Enhancing Clean Claims Rate for Efficient OB/GYN Billing
Nothing slows reimbursements down more than claims errors. Claims submission and OB/GYN
billing errors are consistently cited as the leading cause of hospital and physician claim denials.
However, errors such as patient demographic data discrepancies are often entirely avoidable.
A technological upgrade can assist you in detecting claims errors before they are submitted,
reducing delays and denials. Automation diminishes the chances of human error and
streamlines the clumsy processes that cause errors in the first place, such as patient data
validation and insurance verification.
Aside from reducing manual processes, a single system for managing all claims with all payers
is easier for OB/GYN billing staffers to navigate, resulting in better overall outcomes.
● Better Leveraging the Available Data
Obstetricians-gynecologists can access a wealth of primary source data on OB/GYN billing,
patients, and demographics. The challenge is to gain access to that data and use it in the most
beneficial way for the healthcare organization. Technology enables healthcare organizations to
not only systematize the data collection process but also to visualize it in a way that allows us
to draw meaningful conclusions.
Medical leaders are better analysts of what’s happening with the balance sheet today and
predict what’s in store for tomorrow if they can easily access precise, up-to-date data on
metrics like net collection rate and days outstanding sales. Further investigation enables
process improvements that can improve overall financial health.
Collaborate with 24/7 Medical Billing Services!
Despite optimistic predictions at the start of 2023, patient volumes have not recovered to pre-
pandemic levels. In many cases, they are still declining. Meanwhile, the ongoing healthcare
staffing shortage makes attracting qualified workers more complex than ever, while existing
labor resources are stretched thin.
The outlook for providers may appear dull, but one area holds great promise for helping them
overcome these and other challenges: technology. The right technology is critical for staff to do
their jobs effectively and make the most of their valuable time on the clock; it’s also essential
for your revenue cycle to run as smoothly as possible. The best way out is to collaborate with 24/7 Medical Billing Services – an OB/GYN billing and coding company using updated technology to bill and code the services.