OB/GYN practices face layered billing scenarios that few specialties deal with simultaneously. The challenge isn’t volume—it’s precision.
Common OB/GYN billing pain points include:
Global maternity billing (antepartum, delivery, postpartum)
Split billing when care transfers between providers
High denial rates for ultrasounds and NSTs
Preventive vs problem-oriented visit conflicts
Modifier misuse (25, 59, 22, 52)
Medicaid pregnancy coverage lapses
Postpartum visit reimbursement delays
Without specialty-trained billers, revenue leaks quietly—often unnoticed until AR balloons.
We don’t treat OB/GYN patients like general medicine patients. Our billing workflows are built specifically for women’s health.
We correctly manage:
CPT global packages (59400, 59510, 59610, 59618)
Antepartum-only or delivery-only scenarios
Provider switches and cross-coverage
Correct use of global vs non-global billing
We ensure proper coding and documentation for:
OB ultrasounds (76801–76830)
Fetal NSTs (59025)
Biophysical profiles
Medical necessity alignment with payer policies
We apply payer-specific logic to bill correctly:
Annual well-woman exams
Contraceptive counseling
Problem-focused visits with modifier 25
Same-day preventive + E/M services
Each service is managed by OB/GYN-focused billing specialists who understand maternity care, global billing rules, and payer-specific requirements.
We verify pregnancy Medicaid eligibility, commercial maternity benefits, visit limits, and authorization requirements before services are provided, reducing eligibility-related denials and payment delays.
Certified OB/GYN coders review documentation to assign accurate CPT, ICD-10, and modifier combinations while ensuring medical necessity and proper linkage for maternity and gynecologic services.
Every claim is scrubbed against global OB rules, payer edits, diagnosis sequencing, and bundling guidelines before submission to prevent rejections and accelerate reimbursements.
ERA and EOBs are posted accurately and transparently, allowing us to detect underpayments, payer errors, and delayed claims while maintaining clean patient accounts.
We analyze OB-specific denial trends, correct coding or documentation gaps, and submit strong, evidence-based appeals to recover lost or underpaid revenue.
Monthly reports provide clear insights into AR aging, collections, denial rates, top CPT codes, and payer performance, helping your practice stay compliant and financially informed.
OB/GYN practices face frequent audits due to maternity billing volume and Medicaid oversight.
Key compliance risks include:
Incorrect global period billing
Missing delivery documentation
Modifier misuse on E/M services
Ultrasound frequency denials
Postpartum visit nonpayment
Swiftcare Solution: We implement documentation templates, internal audits, and payer-specific rule sets to reduce audit exposure and protect reimbursements.
We integrate directly into your existing EHR and practice management systems, so your team keeps working the way it already does: no software changes, no retraining, and no disruption to patient care or clinical operations.
Supported platforms include:
Our billing team integrates into your current workflow, ensuring accurate charge capture, real-time claim visibility, and seamless communication between the clinical and billing teams. We adapt to your processes—not the other way around.
We support a wide range of women’s health providers with billing strategies tailored to their clinical and operational needs:
OB/GYN private practices
Multi-provider women’s health clinics
High-risk pregnancy and maternal-fetal medicine centers
Community health clinics
Hospital-affiliated OB/GYN groups
Whether your practice manages 30 deliveries a month or 300, our services scale with your volume, payer mix, and growth goals—without sacrificing accuracy or compliance.
Maternity billing is complex, but it shouldn’t slow your practice down. Swiftcare Billing becomes your dedicated OB/GYN revenue partner, handling every detail with precision, compliance, and proactive follow-up—so you can focus on patient care and practice growth.
Have questions or need support? Our team is here to guide you with credentialing, billing, coding, and A/R solutions tailored to your practice. Reach out now to get started.
