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OB/GYN medical billing demands expertise across global maternity billing, gynecological surgery, preventive care, ultrasound services, contraception management, and payer-specific reimbursement rules
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Choosing between global obstetric billing and split billing directly impacts reimbursement. Antepartum visits, delivery, postpartum care, and provider participation must align with payer rules before claims are submitted.
Hysterectomy, laparoscopy, hysteroscopy, colposcopy, and other gynecologic procedures require accurate CPT selection, modifier use, operative documentation, and medical-necessity support.
Well-woman exams, preventive visits, contraceptive device insertion, family planning services, and screening services frequently involve payer-specific preventive benefits that require precise coding.
Our certified OB/GYN medical coders specialize in ICD-10-CM, CPT, HCPCS, maternity care, gynecologic surgery, preventive medicine, infertility services, and women's health reimbursement.
Olympus AI validates coding, payer edits, documentation requirements, and reimbursement opportunities before claims are submitted, reducing preventable denials.
We manage eligibility verification, prior authorization, coding, claim submission, payment posting, denial management, A/R follow-up, patient billing, and financial reporting through one integrated workflow.
We accurately manage prenatal care, labor and delivery, postpartum services, multiple providers, and global maternity packages while maintaining payer compliance.
Our team navigates commercial insurance, Medicare, Medicaid, and managed care plans, using payer-specific billing workflows to reduce reimbursement delays.
Clear patient statements, accurate benefit verification, transparent billing, and proactive communication improve collections while strengthening patient satisfaction.
Partnering with Plutus Health has transformed our OB/GYN revenue cycle. Their understanding of maternity billing, gynecologic procedures, payer requirements, and denial management has significantly improved our reimbursement while allowing our physicians to focus on patient care.
OB/GYN billing includes gynecological procedures, obstetric services, maternity care (prenatal, delivery, postpartum), special obstetric codes, gynecological surgery codes, proper E/M coding for pregnancy visits, and managing the unique aspect of obstetric global packages.
The obstetric global package bundles prenatal care, delivery, and postpartum care into one payment. Understanding which services are included vs separate, proper coding for complications, managing antepartum/postpartum only cases, and navigating payer variations is critical for accurate OB billing.
Challenges include proper global package management, antepartum-only and postpartum-only situations, pregnancy complication coding, procedure vs evaluation distinction, E/M level coding for pregnancy visits, gynecological vs obstetric code selection, and managing high-risk pregnancy documentation.
Plutus Health optimizes through specialized OB/GYN coders, proper global package administration, accurate antepartum/postpartum coding, comprehensive pregnancy complication documentation, proper procedure coding, authorization management, and denial prevention specific to obstetric services.
OB/GYN practices using Plutus Health achieve clean claim rates of 97%+, reduced denials related to global package confusion, proper capture of all billable services, faster payment processing, improved compliance, and increased revenue through optimized billing practices.
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