July 18, 2024

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How to Make Obgyn/Gynecology Billing Services Better?

How to Make Obgyn/Gynecology Billing Services Better?

No doubt Obgyn/Gynecology billing services require a commodious claim filing system. It involves all the services related to family planning, gynecology, obstetrics, and anesthesia procedures. But when it comes to revenue reimbursement then the specialty face so many challenges. Such as omitting modifiers, under-coding, and submitting claims without any accuracy in the documentation are the most prominent challenges faced by gynecology professionals. The lost revenue is also a big loss.

Obgyn/Gynecology billing Services are Fraught with Difficulties

No doubt Obgyn/Gynecology billing services require a commodious claim filing system. It involves all the services related to family planning, gynecology, obstetrics, and anesthesia procedures. But when it comes to revenue reimbursement then the specialty face so many challenges. Such as omitting modifiers, under-coding, and submitting claims without any accuracy in the documentation are the most prominent challenges faced by gynecology professionals. The lost revenue is also a big loss.

Improve Obgyn/Gynecology Billing Services 

Below are the ways that can help you to improve your obgyn/gynecology billing and increase your revenue.

  • Understanding and Information of The Coding Updates
  • Prevent Common Causes for Denials
  • Eye on ICD – 10
  • Hiring Efficient Billers

Understanding and Information of The Coding Updates 

  • Best way to understand and make sure that the claims aren’t purposely denied is to stay well-informed about the coding updates it will also affect your gynecology practice
  • In the last decade there were several changes occurred in the CPT codes and it’s essential to stay updated
  • For Example, in the year 2017 there was a deletion of the bull’s eye symbol, which indicated moderate sedation that is commonly used for gynecology procedures. This symbol was deleted due to several CPT codes which include 10030 (collection of fluid drainage by catheter) and 49407 (retroperitoneal or peritoneal, trans-rectal or trans-vaginal).
  • When the practice fails to stay up-to-date on CPT coding, it’s hard to lose thousands of dollars. It’s important to work with experienced coders who have all the current knowledge of obgyn/gynecology billing services.

Prevent Common Causes for Denials 

Being aware of the claim denials is also a way to avoid them. A healthcare professional has the report in the past which includes some unexpected denials. Those denials are the following

  • 99000 – an office lab is handling a specimen
  • 36145 – Routine blood capture
  • 99213 – Outpatient visit doctor at level 3
  • 99214 – An outpatient visit doctor at a level 4
  • 81002 – Urinalysis without a scope

All of these denials occur due to several reasons in most cases they get a code 18 denial for duplicate claim service. Commonly, most of the claims get denied because the service benefit was already included in the payment and another procedure service.

These claims get denied because the procedure isn’t paid separately or the change is not covered by the insurance company or maybe also the claim includes errors or lack of essential information that is required for reimbursement.

Keep an Eye on ICD – 10 

Most of the practices now follow ICD-10 coding. But below are a few tips to remember to reduce claim denials for obgyn/gynecology billing services.

  • Causes of the pelvic pain need to be documented soon after knowing it
  • If the patient’s age is over 35 years and she is having a complicated pregnancy then it needs to indicate whether their age may affect their delivery
  • It is compulsory to document the accurate reason if the fetus visibility scans are performed. Specify if it’s the routine screening or if there have been signs that would indicate a potential miscarriage.
  • Specific trimesters must be documented. For instance, the new ICD-10-CM code for the supervision of a pregnancy with a history of infertility during the first trimester can help assure appropriate coding and allow for fewer denials. Be mindful of any codes that can change depending on the particular trimesters.

Hiring Efficient Billers 

  • The obgyn/gynecology billing and the coding team must know about the fee schedule, commercial payer regulations, and Medicare and Medicaid guidelines.
  • The team should be active and expert in answering patient’s queries regarding gynecology billing
  • Data and charge entry must be absolute
  • The billing team should be compliant with all HIPAA rules and regulations to assure accurate and complete billing
  • Accounts Receivable Management strives in reducing denials
  • Credentialing of the physician for the hospital is necessary
  • They should be experts in payment posting
  • The team should be expert in handling denials through dedicated revenue management
  • There should have Electronic Data Interface

End Note

If you avoid all of the things mentioned above, then I can assure you that you will have the best OB/GYN billing services and your revenue will increase within a few days.