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We are home to OB/GYN coding specialists certified in COBGC and billers recognized by AAPC and AMA. We streamline your entire billing process by leveraging well-defined processes and the latest OB/GYN-specific billing software. Our services offer billing support to gynecology providers, offering antepartum care, delivery services, postpartum care, infertility services, routine gynecological exams, screenings (such as Pap smears), and surgical procedures, among others. Here's how we optimize your billing operations:
- Integrate digital systems such as electronic medical records (EMR), electronic health records (EHR), and electronic data interchange (EDI) into gynecology-specific billing software to modernize and streamline billing processes, replacing manual tasks with efficient electronic claims processing workflows.
- Collate all patient information, including demographics, medical history, and referrals, and thoroughly verify insurance details such as coverage type, prior authorization status with effective dates and expiration dates, and claims address to ensure accurate claims documentation.
- Confirm if pre-authorization is required for any gynecology services rendered and request approval from payers if necessary.
- Ensure code specificity and compliance with regulatory guidelines when managing various OB/GYN billing models, including value-based care, fee-for-service, capitation, and global billing.
- Align claims documentation with the latest CPT, ICD-10, and HCPCS level II code ranges.
- Leverage digital workflows to ensure OB/GYN code precision (56405 – 58999 CPT code range) while creating claims documentation to capture diagnosis, services, and equipment accurately.
- Stay on top of fee schedules and claims submission guidelines for all payers (Medicare, Medicaid, Marketplace plans, Tricare, VHA, and private insurers like Blue Cross Blue Shield, Cigna, etc.) to minimize claims denials and maximize reimbursements.
- Review claims against Explanation of Benefits (EOB) provided by payers to pinpoint causes of claims denials. Resolve discrepancies and initiate the appeals process as necessary.
- Communicate with payers to generate patients' benefits and gain clarity on deductibles, copayments, and coinsurance. Inform patients on their patient responsibilities to prevent unpaid bills.
- Assign certified patient accounts representatives to ensure precise processing of electronic payments for each patient account from the payers.
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