Understanding the basics of Gynecology Billing and coding workflow
Obstetrics & Gynecology (OB/GYN) is a medical specialty that focuses or mainly deals with women’s care, especially during pregnancy and child birth, and diagnosing and treating diseases of the female reproductive organs. Additionally, OB/GYN practitioners also address other women’s health issues as well such as – menopause, hormone problems, contraception (birth control), infertility and more.
In fact, in OB/GYN practice, various procedures are performed, including surgeries, pre and postpartum healthcare, and regular health screenings for women. Despite being such a vast area, its billing and coding can be quite challenging for many providers. In fact, in the case of gynecology billing, there are several complexities involved like – global claims, varying coverage terms, and multiple tests performed at different facilities; which is often the reason for chaos for many. This is mainly because most of us have seen that, unlike large hospitals and small clinics many OB/GYN practitioners lack dedicated billing support; as a result, common billing and coding errors occur, impacting the overall revenue and hindering growth.
In fact, here are a few common gynecology billing errors:
- Overlooking separately billable services rendered during the global period: One of the common errors in OB/GYN billing is not recognizing all the services that can be billed separately during the global period. This oversight can lead to a mess and also missed revenue opportunities
- Lack of understanding that pregnancy coverage is an amendment to an existing insurance plan: for many it is often unclear that the pregnancy coverage is typically an amendment to an existing insurance plan, and it includes both inpatient and outpatient services. Understanding this distinction is crucial for accurate billing and coding.
- Improper documentation of policies and services provided: Proper documentation is essential in OB/GYN billing. This is because inadequate documentation or wrong data and information will only result in claim denials or downcoding, leading to decreased reimbursement.
- Misunderstanding of the criterion for coding various levels of ground and air ambulance services: OB/GYN billing involves coding for various levels of ground and air ambulance services as well. Thus, it’s vital to have a clear understanding of the criteria that determine the “medical necessity” for these services to ensure accurate coding and reimbursement.
In fact, with all such confusion and in today’s competitive market, it is best advised to have an expert managing your gynecology billing.
Sunknowledge the powerful gynecology billing solution
A team like Sunknowledge Services Inc with extensive experience in working with obstetricians and gynecologists can not only help you streamline your billing operation but also ensure a faster reimbursement overall for your practices.
Being proficient in ICD-9 / 10, CPT, and HCPCS coding guidelines provided by CMS and AMA, the coders not only ensure a 99.9 % accuracy rate but further ensure lesser claims denial.
Covering all the complex areas starting from Maternal-Fetal Medicine, Reproductive Endocrinology and Infertility, Gynecological Uro-gynecology and Pelvic Reconstructive Surgery, Advanced Laparoscopic Surgery, Family Planning, Pediatric and Adolescent Gynecology, Menopausal and Geriatric Gynecology, among others, Sunknowledge not only help in closing all your billing gaps faster and efficiently.
Preventing your claim denials while increasing the reimbursements rate, Sunknowledge by adhering strictly to coding and billing guidelines further leverages modern technology and assist you with improved ROI and better patient care. Shifting your focus from denial management to denial prevention, the expert ensures timely claims submission every time and works to minimize denials.
Providing tailored customized solutions that help reduce denials and increase revenue, choosing Sunknowledge Services Inc., for OB/GYN billing and coding services brings finesse and accuracy to your practice’s reimbursement process and improvement in focusing on patient management and care
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