Obstetrics and gynecology (OBGYN) reimbursements continue to get more complicated. MedCare MSO provides end-to-end OBGYN Medical Billing Services backed by AAPC-certified coders who manage global OB packages, obstetric ultrasound splits, gynecology procedures, and prenatal care to reduce denials. Our experts ensure we capture every detail, protecting your reimbursements throughout the full maternity and gynecology lifecycle.
OBGYN billing services work tightly around maternity care and preventive coverage. Outsource your medical billing to an experienced OB GYN billing company to increase your collections while lowering your burden of routine administrative tasks off your front desk.
Our OBGYN billing services take care of every phase of women's health care with the meticulous care it deserves. Our women’s health billing services are a calculated combination of certified coders, automation, and compliance discipline into one accountable partner.
OB/GYN billing services need the attention of a specialist to resolve complex issues related to combining episode-based global packages, high volume in office procedures, gynecologic surgery, and preventive care rules that all interact, so even a minimal miss can pile up several denials across an entire pregnancy episode.
The global maternity package bundles antepartum, delivery, and postpartum care into one single code (59400 to 59622). Even if a single visit, an early delivery or a transfer gets missed from documentation, reimbursement for the whole episode can be jeopardized.
Vaginal (59400), cesarean (59510), VBAC (59610), and VBAC after a failed trial (59618): each of these cases has distinct codes and global rules. The paper work needs to record the method, complications, and if the provider offered the full package.
Preventive screenings, including pap smears and mammograms, are covered at 100% of their claim value. While the same services coded under the head of diagnostics prompt cost sharing. If the screenings or diagnostics are categorized incorrectly, patients may receive surprise bills and real compliance exposure.
The two mostly come down to a single diagnosis code and how it is put into sequence. A visit that starts as a routine screening can turn diagnostic the moment a provider documents a finding, and the claim has to reflect that. We code each visit to what the documentation supports, apply modifier 33 for genuinely preventive services, and use modifier 25 when a problem visit and a preventive one fall on the same day. That keeps patients billed correctly and your practice defensible under review.
Our gynecology billing services span hysterectomy, myomectomy, laparoscopy, and endometriosis, each with open, laparoscopic, and robotic variants. Global periods, multiple procedure reductions, and assistant surgeon rules pile on further.
Obstetric ultrasounds (76801 to 76828) vary by trimester, completeness. It can be either of doppler or biophysical components. Professional and technical splits need modifier 26 or TC depending on who owns the equipment.
When more than one gynecologic procedure is performed in one session, commercial payers and Medicare uses multiple procedure multiple reductions. Modifier 51 and correct sequencing protect your entire claim payment. This is the core around which our OBGYN medical billing services are built.
When prenatal care is shared or a patient is referred to another doctor mid pregnancy, antepartum visits bill individually with CPT code 59425 for four to six visits or 59426 for seven or more, never as a global package.
Our OBGYN medical billing services run the full claim lifecycle, from the first eligibility check to the last dollar amount recovered, under one OBGYN revenue cycle management program. Each process in our OB GYN billing services is built for the pregnancy episode and the gynecology procedure alike.
We confirm coverage, maternity benefits, and network status before even the first prenatal visit.
Authorizations for cesarean sections, gynecologic surgery, and advanced imaging are confirmed before providing the service.
Our OBGYN medical billing services record every antepartum visit, ultrasound, and add on service.
Our OBGYN medical billing and coding team, all CPC and COBGC certified, assigns CPT, ICD-10-CM, and HCPCS codes from the documentation.
Every claim is checked against NCCI edits and payer specific rules before they are submitted, so bundling conflicts are resolved within our OB GYN billing services.
Clean claims go out daily through your clearinghouse, with payer specific edits applied so first pass acceptance stays high.
ERAs and EOBs are posted daily and reconciled against contracted rates, with underpayments flagged and worked rather than accepted.
Our OBGYN claim denial management team works rejections to root cause and appeals within 24 to 48 hours with the clinical documentation each payer requires.
Clear patient statements go out promptly, and real time dashboards show clean claim rate, days in A/R, and denial trends by CPT family.
Our OB/GYN billing services cover the full scope of women’s health practices, including obstetrics, gynecology, preventive care, and specialized services. Our women’s health billing services include infertility evaluations, endometriosis care, abnormal uterine bleeding, and menopause management with documentation that supports medical necessity.
As an OB/GYN billing company, we are flexible enough to cover the following subspecialties:
| Subspecialty | What We Bill |
|---|---|
| Advanced Laparoscopic Surgery | Diagnostic and operative laparoscopy, adhesiolysis, and excision procedures (58660 to 58679), with correct approach and multiple procedure sequencing |
| Family Planning | IUD and implant insertion and removal, sterilization, and contraceptive counseling (58300, 58301, 11981 to 11983), coded with Z30.x diagnosis support |
| Gynecologic Oncology | Radical hysterectomy, staging, and tumor debulking (58210, 58548, 58951), coded with the ICD-10 specificity payer review demands |
| Maternal-Fetal Medicine | High risk antepartum management, detailed fetal ultrasound (76811, 76812), and amniocentesis, billed separately from the global maternity package |
| Menopausal & Geriatric Gynecology | Hormone management, osteoporosis screening, and problem visit E/M coded distinct from any preventive well woman exam on the same day |
| Minimally Invasive Gynecologic Surgery | Hysteroscopy, myomectomy, and endometrial ablation (58558 to 58565), with open, laparoscopic, and robotic approach variants captured correctly |
From the first prenatal visit to postpartum closeout, our certified coders catch the revenue generalist billers leave behind, across global packages, component splits, and same-day procedures.
Get My Free OBGYN Billing AuditOur AI-powered OB GYN medical billing services let you add a single product to fix your biggest bottleneck, or connect the complete AI ecosystem into your OBGYN revenue cycle management. Either way, each piece integrates with the EHR you already run.
Centralizes women's health records with clinical workflows that feed charge capture the moment care is documented.
Captures each prenatal and gynecology visit as structured clinical documentation, right at the point of care.
Assists with OBGYN CPT, ICD-10, and HCPCS assignment for maternity and gynecology, under certified coder review.
Runs scheduling, eligibility, and claims from one platform, with dashboards on collections by provider and payer.
What makes MedCare MSO a trusted provider of OBGYN billing services is not only the technology. It is AAPC certified coders delivering OBGYN medical billing services with deep women's health experience, paired with AI validation and HIPAA compliant workflows that protect your revenue and your practice.
In women's health billing, a single outdated policy can trigger claim reversals and audit exposure across every case that followed it. We align every claim with ACOG coding guidance, CMS global surgery rules, and current NCCI edits, and we verify the medical necessity link between diagnosis and procedure before submission.
Every workflow is HIPAA compliant and audit ready, and we audit coding quality on a recurring schedule so drift is caught internally rather than by a payer. That discipline is what keeps your OBGYN billing services defensible and your reimbursement protected as the rules change.
OBGYN billing refers to a global maternity package that includes antepartum, delivery, and postpartum care in one code. Because of the large volume of same-day procedures, ultrasound splits, and stringent Medicaid rules, specialty coders are required to take care of an entire maternity episode instead of one visit.
Our OBGYN medical billing services bill 59400, 59510, 59610, or 59618 when one provider handles the full episode. If the care is divided between several providers or if the patient switches caregivers during the pregnancy, we file component codes like 59425 and 59409 to make sure that the work is compensated accordingly.
To prevent the denials, we check insurance coverage before the appointment, make sure that all claims meet the NCCI standards by scrubbing them, and use modifier 25 properly when two visits take place on the same day. When denials occur, our OBGYN claim denial management team appeals within 24 to 48 hours.
Both. If your billing team is already in place, we can take the coding alone. Our CPC and COBGC certified coders read each note and assign accurate CPT, ICD-10, and HCPCS codes with the right modifiers, then hand the clean charges back to your team.
Yes. Our OB/GYN billing services integrate with the most popular EHR or practice management systems, which gives you the opportunity to retain the tools already being used by your doctors, or you can choose to shift your entire billing to our AI-driven EHR.
Most practices transition within two to four weeks. We map your workflow, connect to your systems, and run a parallel period, so claims keep flowing while we take over, reconciling any open pregnancy episodes so no maternity revenue slips through the handoff.
Yes. Our OB GYN billing for small practices scales to your volume without the overhead of an in-house team. You can select only the services that you require while continuing with other services in-house and paying only on the amount that is recovered.
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