The maternity global is one payment for nine months of work.
Obstetric care is billed as a package, and everything outside that package has to be identified and billed separately or it is simply given away.
- 97%Coding accuracy on audit
- 50+Specialties covered
- 4.9/5Average client rating
Three ways OB/GYN claims quietly lose value
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- Global package billed when care was split
A patient who transfers in or out mid pregnancy is not a global claim. Billed as one, it is either denied or, worse, paid and recouped.
- Services outside the package not billed
Ultrasounds, non stress tests and problem visits unrelated to the pregnancy are separately payable. Bundled by habit, they are unpaid work.
- Postpartum care not tracked to completion
The package includes postpartum care. When it is not documented as delivered, the payer can reduce the payment after the fact.
What we bill for OB/GYN practices
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How OB/GYN accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- An ob/gyn coder, not a general one
The coder assigned to your account works ob/gyn every day. They already know which of your payers do what, and they are watching global maternity packages, split care and separately payable services.
- Charges checked against the note
Before anything goes out, the charge is read against the documentation. A code the note does not support is a recoupment waiting to happen, and in ob/gyn it is usually the highest value code on the claim.
- Eligibility and authorization ahead of the visit
Coverage is confirmed and any approval is in place before the service, not discovered afterwards when the work has already been done.
- Denials worked to cause, not just refiled
Every denial is tagged by payer and reason code. When a pattern shows up in your ob/gyn claims we change the upstream step so it stops recurring.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for OB/GYN practices
- Coders who work ob/gyn daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
OB/GYN billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate OB/GYN service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat OB/GYN practices ask
How do you handle a patient who transfers care?
As split care, billed for the portion you actually provided, with the antepartum visit count documented.
Are ultrasounds inside the global?
Generally no. They are separately payable and routinely missed.
Do you bill IUD insertion and the device?
Yes, both, and the device has its own supply rules.
What about problem visits during pregnancy?
Separately payable when unrelated to the pregnancy and documented as such.
Have an ob/gyn coder read your last ninety days
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.