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OB/Gyn (Obstetrics and Gynecology) practices face a unique set of challenges in the healthcare billing industry. With constantly changing payer policies, coding updates, and compliance regulations, accurate billing becomes critical for maintaining a sustainable and profitable practice. That’s where CareMSO steps in—offering dedicated OB/Gyn medical billing services that ensure maximum reimbursements with minimal hassle.
OB/Gyn billing is more than just submitting claims. It involves understanding:
Complex CPT & ICD-10 codes
Bundling rules and global billing for maternity care
Insurance verification for prenatal and postpartum visits
Medicaid and Medicare policy updates
Reimbursement cycles across multiple payers
Incorrect billing can lead to:
Revenue leakage
Increased denials
Patient dissatisfaction
Legal and compliance issues
Accurate billing improves cash flow, enhances patient trust, and ensures regulatory compliance.
One of the most complex areas is billing for the entire obstetric episode, which includes:
Prenatal visits
Delivery
Postpartum care
Understanding what’s included under global billing and what should be billed separately (e.g., ultrasounds, non-routine visits) is critical.
OB/Gyn practices deal with a wide array of procedures—from colposcopies and hysteroscopies to IUD insertions. These require constant coding updates, which can be overwhelming for in-house staff.
Procedures like hysterectomies or surgeries require prior authorizations. A lack of robust eligibility verification may result in claim denials or patient billing errors.
OB/Gyn claims are prone to denials due to:
Incorrect modifiers
Missing documentation
Global billing misunderstandings
CareMSO provides end-to-end OB/Gyn billing solutions for clinics, solo practitioners, and multi-physician groups across the USA. Our team specializes in billing for:
Prenatal and maternity care
Routine gynecological exams
Surgeries like D&C, laparoscopies
Infertility treatments
Pap smears, ultrasounds, and screenings
We tailor our workflow to match your practice management system and specialty needs.
Our coders are AAPC and AHIMA certified, with deep experience in women’s health services coding.
We track every denial, analyze root causes, and ensure resubmissions are handled promptly.
Your data privacy is protected with HIPAA-compliant systems and infrastructure.
We provide detailed monthly reports on:
Claims submitted
Reimbursements
Denials
Pending A/R
59400 – Routine obstetric care including antepartum, delivery, and postpartum
58120 – Dilation and curettage
57500 – Cervical biopsy
58300 – Insertion of IUD
76805 – Obstetric ultrasound, complete
O80 – Encounter for full-term uncomplicated delivery
N80.0 – Endometriosis of uterus
Z12.4 – Encounter for screening for malignant neoplasm of cervix
Z30.430 – Encounter for insertion of intrauterine contraceptive device
OB/Gyn billing must comply with:
HIPAA privacy and security rules
CMS guidelines for documentation
Stark Law and Anti-Kickback Statute
AMA and ACOG recommendations
At CareMSO, we continuously audit our billing processes to ensure 100% compliance with state and federal regulations.
Our optimized billing processes help improve your revenue by reducing denials and capturing every billable code.
Focus on patient care while we manage your billing, coding, and payer communications.
With clean claim submissions and electronic remittance, we ensure quicker payments.
Whether you’re a solo OB/Gyn or part of a multi-specialty group, our services scale with your growth.
Patient Demographics & Insurance Entry
Eligibility Verification & Authorization
Medical Coding (CPT, ICD-10, HCPCS)
Charge Entry & Claim Submission
Payment Posting
Denial Management & Appeals
Patient Statements & A/R Follow-up
Monthly Analytics & Reporting
Integrated EHR systems
Claim scrubbers for code validation
Real-time eligibility check tools
HIPAA-compliant cloud storage
KPI dashboards for performance tracking
We are compatible with platforms like Athenahealth, eClinicalWorks, Kareo, AdvancedMD, NextGen, and more.
After outsourcing billing to CareMSO, collections increased by 27% in the first quarter. Denial rates dropped by 45%.
CareMSO streamlined her claims and reduced billing errors by integrating with her EHR and offering real-time coding updates.
We cover maternity, gynecology, fertility, routine wellness, and surgical procedures.
We ensure a smooth onboarding process within 7-14 business days.
Yes, both are part of our full-service OB/Gyn billing package.
Absolutely. We provide monthly and on-demand reporting with complete transparency.
Yes, all our operations, software, and staff practices follow strict HIPAA protocols.
OB/Gyn medical billing is intricate, but with the right partner, it doesn’t have to be overwhelming. CareMSO helps you streamline your practice, maximize revenue, and enhance patient satisfaction with end-to-end billing solutions designed for women’s health providers. Trust our certified experts to handle the complexities so you can focus on delivering exceptional care.
