You may think that the most simplest and straightforward specialty in the entire medical field is OB-GYN, but guess what, it ain’t. Not only does this field covers procedures like Gynecology and Family Planning but also takes under Anesthesia and Obstetrics. This means even the simplest procedures can end up having complex billing codes, which can lead to billing errors affecting your revenue. 

In-house billing can severely affect your practice revenue and put your business at risk of shutting down. There’s one thing you can do to avoid such a disaster and get paid on time for your services. Outsource your billing to a OB GYN billing company service provider and see your business booming without having to worry about denials, late payments, untimely claims submissions, and other common errors.

OB GYN Billing Company can Greatly Benefit Your Practice

  • Get timely payments for your services

When you outsource to an OB GYN medical billing company, it becomes their duty to get you paid for all the services you have provided. They would work tirelessly around the clock to submit claims on time and make sure it’s error-free so there are no denials.

  • You won’t need to rely on incompetent in-house billing staff

You cannot count on your in-house billing staff as they are not properly trained for billing. This can cause claim errors and denials. Moreover, if an employee gets sick or decides to go on a vacation, your cash flow will be affected. 

With a ob gyn billing service provider, your claims submissions won’t be stopped and your collections won’t be disturbed.

  • Save extra costs and get paid more accurately

An OB-GYN billing company already has a team of experts that will look after your bills.  You won’t have to hire or train in-house staff for your billing, hence you’ll be saving costs over-heads with an increased reimbursement rate.

  • Lesser to Zero Denial Rate

A reliable billing service provider makes sure their team is always updated with the ever-changing codes and regulations. They constantly train and test their staff to see if they check all the boxes of an expert biller and coder. When a provider is dedicated, they’ll make sure there are fewer to no denials of your submitted claims and you get the maximum of your service.

  • Transparency in full

Your data will always be completely accessible to you and the designated staff members. There is nothing a trusted ob gyn medical billing provider wants to keep from you. The notes will be added to the patient’s chart when we do follow-ups, where you can review them. They support complete openness.

  • More time for focused patient care

Health professionals have more time to focus on patients when the billing functions are delegated to an ob gyn billing company, as opposed to spending time on their own billing procedures. Business-wise, you should focus on your core competencies, such as providing high-quality patient care and contracting out ancillary business operations to service providers.

How does the Ob-Gyn Billing company processes 

The series of procedures surrounding healthcare payments, starting with the time a patient schedules an appointment and ending with the payment of a provider, is known as the revenue cycle. Consider it in terms of the life cycle of a medical bill as one way to frame it. Although this process can occur in a variety of ways, we’ll outline a typical example below.

A Revenue Cycle Management (RCM) lifecycle covers every facet of medical billing, from patient insurance verification to reporting, and ensures that the service provider is paid fairly for each and every claim.

  • Prior appointment

When a patient calls a provider to make an appointment, the revenue cycle for the majority of general care starts. Usually, at this point, pertinent patient data will start to be gathered for the eventual bill, known as a claim on the financial side of healthcare.

If an insurance company’s prior authorization is required for the appointment and procedure, the provider will decide at this time (referred to as the payer). The electronic health record (EHR) that was used to help create the claim also got started at this point and will start to grow as the provider sends an eligibility inquiry to determine whether the patient has insurance.

  • Point of care 

When the patient shows up for their appointment, the process moves on to the following phase. This may occur when a patient shows up for a first appointment, an outpatient procedure, or a follow-up examination. An appointment for telehealth may also be part of this.

The service provider may impose an upfront fee on any of these occasions. Another type of payment that fits into this category is a co-pay, which is the fixed amount patients pay after their deductible if they have insurance.

  • Submission of a claim

Following the point of care, the provider completes and sends a claim to the payer with the proper codes. Ob gyn billing company staff must gather all required supporting documentation and attach it to the claim in order to achieve that.

The  ob gyn medical billing provider’s team will keep track of whether a claim has been approved, denied, or rejected after submitting it to the payer.

  • Payment or Denial

When the payer receives the claim, they make sure it is accurate and matches the provider’s and the patient’s records. If a mistake is found, the claim will be automatically rejected, and the provider will need to submit a revised claim.

The adjudication process, which is a review process, is then started by the payer. Payers review claims to ensure that the coding, documentation, medical necessity, authorization, and other criteria are correct. The payer determines their financial obligation through this process. The payer could reject the claim for any reason.

If the claim is accepted, the payer sends the ob gyn medical billing service provider their payment along with information outlining the specifics of their choice.

If the claim is rejected, the provider must decide whether to correct the original information or whether it makes more sense to challenge the payer’s ruling.

The payer will send the patient an explanation of benefits (EOB) following adjudication. This EOB will detail how the patient’s insurance compares to the costs associated with their care. Although it is not a billing statement, it does include information on the amount the provider charged the payer, the percentage that insurance will cover, and the patient’s share of the cost.

  • Patient compensation

The next step is when the ob gyn billing company sends the patient a statement outlining their share of the cost. Once the provider and payer have reached an understanding regarding the specifics of the claim, what has been paid, and what is still owed, this stage begins.

When a patient makes the payment that they owe the provider for their care, the process is complete. The patient may be able to pay the full amount at once, or they may need to work with the provider to establish a payment schedule, depending on the amount.

Final Thoughts

For good reason, outsourcing  medical billing is becoming more and more popular among healthcare providers. It improves productivity, lowers expenses, and frees up medical service providers to concentrate on their patients. The advantages of a patient-centered strategy are crucial in particular for the highly individualized field of OB/GYN. If you’re considering outsourcing your billing to an ob gyn billing company, the above mentioned points will greatly help you decide whether or not you need to outsource. 

Categories: Business

Nicolas Desjardins

Hello everyone, I am the main writer for SIND Canada. I've been writing articles for more than 12 years and I like sharing my knowledge. I'm currently writing for many websites and newspapers. I always keep myself very informed to give you the best information. All my years as a computer scientist made me become an incredible researcher. You can contact me on our forum or by email at [email protected].