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OB/GYN Medical Billing

Outsourcing OB/GYN medical billing can significantly improve a practice’s efficiency. Stars Pro qualified medical billing team handle the complexities of coding, claim submission, and denial management, freeing up valuable time for OB/GYN staff to focus on patient care.
Call Us

Professional Cardiology Medical Billing

Our professional OBGYN medical billing experts offers specialized expertise to the complexities of coding and reimbursement for a wide range of women’s health services.  Our obgyn medical billing services ensure accurate coding for everything from routine gynecological checks to deliveries, while also addressing the complexities of billing, A/R and coding.

By outsourcing medical billing to Stars Pro, OBGYN practices can achieve smoother workflows, minimize administrative burdens for staff, and maximize their financial return by receiving appropriate reimbursement for the care they provide.

Our OB/GYN Medical Billing Process

OB/GYN medical billing involves a specific set of steps to ensure accurate coding and timely reimbursement for the diverse services provided. Here’s a breakdown of the typical OB/GYN medical billing process:

Patient Registration and Insurance Verification

During patient intake, demographic information and insurance details are collected. Our billing expert verifies insurance coverage and eligibility specifically for OB/GYN services planned for the visit.

Charge Capture and Coding

After the patient encounter, the physician documents the provided services. A medical coder then translates this documentation into specific medical codes using ICD-10-CM for diagnoses and CPT® codes for procedures. Accurate coding is crucial for proper OB/GYN billing, especially considering the use of modifiers for complex deliveries or additional procedures.

Claim Submission

The coded information is used to generate an electronic claim for the insurance company. This claim details the services provided, the corresponding codes, and the amount being billed.

Payment Posting and Reimbursement

The insurance company processes the claim and determines the allowed amount based on patient coverage and contracted rates. Once received, the payment is posted to the patient's account.

Denial Management

Sometimes, insurance companies may deny claims due to errors or missing information. The billing team meticulously reviews denied claims, identifies the reason for denial, and works to appeal them with the insurance company to secure proper reimbursement.

Patient Billing and Collections

The patient may be responsible for co-pays, deductibles, or any uncovered charges. The billing team will generate patient statements and handle the collection process, which may involve sending reminders or contacting patients directly.

What are Benefits of Outsourcing OBGYN Medical Billing?

Managing the complexities of OB/GYN medical billing in-house can divert valuable resources away from patient care. Outsourcing these services to a professional medical billing company offers a multitude of benefits for your practice:
  • Enhanced Efficiency and Reduced Costs:

Focus on Patient Care: By offloading billing tasks, your OB/GYN physicians and staff can dedicate more time to patient interaction and overall practice management.

Reduced Overhead: Outsourcing eliminates the need to hire, train, and manage dedicated billing staff. This saves on salaries, benefits, and office equipment costs.

  • Expertise in OB/GYN Coding and Reimbursement:

Accurate Coding: Experienced medical billers ensure proper coding for prenatal care, deliveries (including complexities), and various gynecological procedures. This maximizes your reimbursement potential.

Staying Up-to-Date: Regulations and coding requirements constantly evolve. Outsourcing partners keep your practice compliant, minimizing the risk of audits and maximizing revenue.

  • Improved Revenue Cycle Management:

Faster Reimbursement: Streamlined processes lead to faster claim submissions and quicker turnaround times for insurance payments, improving your cash flow.

Reduced Denials and Rejections: Expertise in OB/GYN billing minimizes coding errors that can lead to claim denials and rejections, ensuring you receive what’s due.

  • Streamlined Patient Billing and Improved Patient Satisfaction:

Clear Communication: Outsourcing billing can ensure smoother billing processes with fewer errors, leading to more satisfied patients.

Efficient Collections: Professional billers handle patient billing and collections efficiently, minimizing confusion and improving patient experience.

  • Peace of Mind and Scalability:

Dedicated Support: Outsourcing partners provide dedicated teams to manage all aspects of your OB/GYN billing, giving you peace of mind.

Scalability for Growth: As your practice expands, your billing partner can easily scale their services to accommodate your increasing billing needs.

What CPT Codes are Used by OBGYN Physicians in Medical Billing?

OB/GYN physicians utilize a variety of Current Procedural Terminology (CPT®) codes for medical billing purposes. These codes categorize the specific services provided during patient encounters. Here’s a breakdown of the key CPT code categories used in OB/GYN billing:
  1. Obstetric Services (56405 – 59899): This is the primary category for OB care, encompassing prenatal care, delivery, and postpartum services. Some specific examples include:
Routine prenatal care: 59030 (initial comprehensive obstetric care), 59040 (subsequent comprehensive obstetric care) Deliveries: 59400 (vaginal delivery without complications), 59510 (cesarean section delivery) Management of high-risk pregnancies: Codes exist for various complications, often paired with global obstetric codes (see below) with specific modifiers.
  1. Global Obstetric Codes (59400, 59510, 59610, 59618): These codes encompass comprehensive care throughout pregnancy, delivery, and postpartum period,  provided by a single physician or group. They are used when the same provider manages the entire pregnancy and delivery.
  2. Gynecological Services (57000 – 59378): This category covers a wide range of women’s health services beyond pregnancy. Examples include:
Pelvic exams: 58140 (complete pelvic exam), 58141 (limited pelvic exam) Pap smears: Pap smears are often billed with an additional code depending on the type performed (e.g., 88154 for Pap smear with endocervical scraping) Colposcopy: 57460 (colposcopy with cervical biopsy) IUD insertion/removal: 58300 (insertion of IUD), 58301 (removal of IUD)
  1. Evaluation and Management Services (E/M Services) (99201-99499):  These codes represent office visits, consultations, and other outpatient services, similar to other specialties. The specific E/M code chosen depends on factors like:

Complexity of the patient’s medical history

Extent of the physical examination performed

Medical decision-making required by the physician

  1. Additional Codes:  Beyond these core categories, OB/GYN physicians may utilize additional CPT codes for specific services they provide, such as:

Ultrasound procedures: Codes vary depending on the type of ultrasound performed (e.g., 76801 for transabdominal ultrasound during pregnancy)

Minor surgical procedures: Codes exist for various procedures performed in the office setting, like biopsies (e.g., 10040 for excision of lesion).

Why OBGYN Choose Stars Pro Medical Billing Services?

OB/GYN practices face a unique challenge: balancing exceptional patient care with the complexities of medical billing. Improper coding and claim errors can significantly impact a practice’s revenue cycle. This is where Stars Pro Medical Billing Services comes in. Here’s why OBGYNs partner with Stars Pro to handle their billing needs:
  1. Expertise in OB/GYN Coding and Reimbursement:

Accurate Coding for Diverse Services: Stars Pro’s team understands the nuances of OB/GYN billing, including prenatal care, deliveries (both routine and complex), and a wide range of gynecological procedures. We ensure accurate coding for all services provided, maximizing your reimbursement potential.

Staying Up-to-Date on Regulations: Medical billing regulations and coding requirements are constantly evolving. Stars Pro keeps your practice compliant with the latest guidelines, minimizing the risk of audits and maximizing revenue.

  1. Improved Revenue Cycle Management:

Faster Reimbursement: Stars Pro’s efficient processes ensure timely claim submissions and quicker turnaround times for insurance payments, leading to improved cash flow for your practice.

Reduced Denials and Rejections: Our expertise helps minimize errors in coding and claim submissions, reducing the likelihood of denials and rejections by insurance companies.

  1. Enhanced Patient Satisfaction:

Clear Communication: Outsourcing billing to Stars Pro can improve communication with patients regarding billing matters, minimizing confusion and frustration.

Streamlined Billing Processes: Efficient billing processes lead to fewer errors and faster check-out times, contributing to a more positive patient experience.

  1. Increased Efficiency and Reduced Costs:

Focus on Patient Care: By offloading billing tasks, OB/GYN physicians and staff can dedicate more time to patient interaction and core practice management activities.

Reduced Overhead Costs: Eliminate the need for hiring, training, and managing dedicated billing staff. Stars Pro helps you save on salaries, benefits, and office equipment costs.

Scalability for Growth: As your practice expands, Stars Pro can easily scale their services to accommodate your increasing billing needs. You won’t need to worry about in-house staffing limitations as your practice grows.

 

By partnering with Stars Pro Medical Billing Services, OB/GYN practices can significantly improve their operational efficiency, financial health, and patient satisfaction. This allows them to focus on what truly matters – providing high-quality care to their patients.
Explore More

FAQ! NEED HELP?

OBGYN medical billing services manage the entire billing cycle for obstetrics and gynecology practices. This includes tasks like accurate coding of prenatal care, deliveries, gynecological procedures, and diagnoses, submitting claims to insurance companies, following up on denied claims, managing patient accounts receivable, and ensuring compliance with regulations.
OBGYN coding involves unique complexities. Stars Pro specializes in OBGYN billing and understands the specific coding requirements for various women’s health services. Outsourcing allows your doctors and staff to focus on patient care while Stars Pro ensures accurate claims and maximizes reimbursements.
Certain procedures in OBGYN care, like some prenatal tests or surgeries, may require prior authorization. Stars Pro can efficiently secure these approvals, minimizing delays and ensuring patients receive timely and necessary care.
Stars Pro’s AR team manages outstanding patient balances. This includes sending patient statements, following up on delinquent accounts, and working with patients on payment plans. Efficient AR management reduces uncollected claims and improves your practice’s cash flow.
Many billing companies, like Stars Pro, offer integration with popular practice management software used in OBGYN practices. This streamlines data transfer between systems, reducing manual entry errors and improving overall efficiency.
Outsourcing practice management tasks frees up your staff to focus on patient care. Stars Pro can handle scheduling appointments, managing referrals, and ensuring accurate patient information, allowing your team to focus on delivering excellent care.
OBGYN billing regulations are subject to frequent updates. Stars Pro stays current on these changes, ensuring your practice remains compliant and avoids potential penalties.
Stars Pro should prioritize patient data security. They should be HIPAA compliant, ensuring all patient information remains confidential.
At Stars Pro, we provide regular reports on key metrics like claim submission rates, denial rates, revenue collection, and coding accuracy. This transparency allows you to track progress and measure the impact of their services on your practice’s financial health.
Beyond core billing services, Stars Pro may offer additional benefits like coding audits, denial management strategies, and performance improvement recommendations. These services can further optimize your revenue cycle management and profitability, allowing you to focus on providing the best possible care for your patients.

OB/GYN Medical Billing

Outsourcing OB/GYN medical billing can significantly improve a practice’s efficiency. Stars Pro qualified medical billing team handle the complexities of coding, claim submission, and denial management, freeing up valuable time for OB/GYN staff to focus on patient care.
Call Us

Professional Cardiology Medical Billing

Our professional OBGYN medical billing experts offers specialized expertise to the complexities of coding and reimbursement for a wide range of women’s health services.  Our obgyn medical billing services ensure accurate coding for everything from routine gynecological checks to deliveries, while also addressing the complexities of billing, A/R and coding.

By outsourcing medical billing to Stars Pro, OBGYN practices can achieve smoother workflows, minimize administrative burdens for staff, and maximize their financial return by receiving appropriate reimbursement for the care they provide.

Our OB/GYN Medical Billing Process

OB/GYN medical billing involves a specific set of steps to ensure accurate coding and timely reimbursement for the diverse services provided. Here’s a breakdown of the typical OB/GYN medical billing process:

Patient Registration and Insurance Verification

During patient intake, demographic information and insurance details are collected. Our billing expert verifies insurance coverage and eligibility specifically for OB/GYN services planned for the visit.

Charge Capture and Coding

After the patient encounter, the physician documents the provided services. A medical coder then translates this documentation into specific medical codes using ICD-10-CM for diagnoses and CPT® codes for procedures. Accurate coding is crucial for proper OB/GYN billing, especially considering the use of modifiers for complex deliveries or additional procedures.

Claim Submission

The coded information is used to generate an electronic claim for the insurance company. This claim details the services provided, the corresponding codes, and the amount being billed.

Payment Posting and Reimbursement

The insurance company processes the claim and determines the allowed amount based on patient coverage and contracted rates. Once received, the payment is posted to the patient's account.

Denial Management

Sometimes, insurance companies may deny claims due to errors or missing information. The billing team meticulously reviews denied claims, identifies the reason for denial, and works to appeal them with the insurance company to secure proper reimbursement.

Patient Billing and Collections

The patient may be responsible for co-pays, deductibles, or any uncovered charges. The billing team will generate patient statements and handle the collection process, which may involve sending reminders or contacting patients directly.

What are Benefits of Outsourcing OBGYN Medical Billing?

Managing the complexities of OB/GYN medical billing in-house can divert valuable resources away from patient care. Outsourcing these services to a professional medical billing company offers a multitude of benefits for your practice:
  • Enhanced Efficiency and Reduced Costs:

Focus on Patient Care: By offloading billing tasks, your OB/GYN physicians and staff can dedicate more time to patient interaction and overall practice management.

Reduced Overhead: Outsourcing eliminates the need to hire, train, and manage dedicated billing staff. This saves on salaries, benefits, and office equipment costs.

  • Expertise in OB/GYN Coding and Reimbursement:

Accurate Coding: Experienced medical billers ensure proper coding for prenatal care, deliveries (including complexities), and various gynecological procedures. This maximizes your reimbursement potential.

Staying Up-to-Date: Regulations and coding requirements constantly evolve. Outsourcing partners keep your practice compliant, minimizing the risk of audits and maximizing revenue.

  • Improved Revenue Cycle Management:

Faster Reimbursement: Streamlined processes lead to faster claim submissions and quicker turnaround times for insurance payments, improving your cash flow.

Reduced Denials and Rejections: Expertise in OB/GYN billing minimizes coding errors that can lead to claim denials and rejections, ensuring you receive what’s due.

  • Streamlined Patient Billing and Improved Patient Satisfaction:

Clear Communication: Outsourcing billing can ensure smoother billing processes with fewer errors, leading to more satisfied patients.

Efficient Collections: Professional billers handle patient billing and collections efficiently, minimizing confusion and improving patient experience.

  • Peace of Mind and Scalability:

Dedicated Support: Outsourcing partners provide dedicated teams to manage all aspects of your OB/GYN billing, giving you peace of mind.

Scalability for Growth: As your practice expands, your billing partner can easily scale their services to accommodate your increasing billing needs.

What CPT Codes are Used by OBGYN Physicians in Medical Billing?

OB/GYN physicians utilize a variety of Current Procedural Terminology (CPT®) codes for medical billing purposes. These codes categorize the specific services provided during patient encounters. Here’s a breakdown of the key CPT code categories used in OB/GYN billing:
  1. Obstetric Services (56405 – 59899): This is the primary category for OB care, encompassing prenatal care, delivery, and postpartum services. Some specific examples include:
Routine prenatal care: 59030 (initial comprehensive obstetric care), 59040 (subsequent comprehensive obstetric care) Deliveries: 59400 (vaginal delivery without complications), 59510 (cesarean section delivery) Management of high-risk pregnancies: Codes exist for various complications, often paired with global obstetric codes (see below) with specific modifiers.
  1. Global Obstetric Codes (59400, 59510, 59610, 59618): These codes encompass comprehensive care throughout pregnancy, delivery, and postpartum period,  provided by a single physician or group. They are used when the same provider manages the entire pregnancy and delivery.
  2. Gynecological Services (57000 – 59378): This category covers a wide range of women’s health services beyond pregnancy. Examples include:
Pelvic exams: 58140 (complete pelvic exam), 58141 (limited pelvic exam) Pap smears: Pap smears are often billed with an additional code depending on the type performed (e.g., 88154 for Pap smear with endocervical scraping) Colposcopy: 57460 (colposcopy with cervical biopsy) IUD insertion/removal: 58300 (insertion of IUD), 58301 (removal of IUD)
  1. Evaluation and Management Services (E/M Services) (99201-99499):  These codes represent office visits, consultations, and other outpatient services, similar to other specialties. The specific E/M code chosen depends on factors like:

Complexity of the patient’s medical history

Extent of the physical examination performed

Medical decision-making required by the physician

  1. Additional Codes:  Beyond these core categories, OB/GYN physicians may utilize additional CPT codes for specific services they provide, such as:

Ultrasound procedures: Codes vary depending on the type of ultrasound performed (e.g., 76801 for transabdominal ultrasound during pregnancy)

Minor surgical procedures: Codes exist for various procedures performed in the office setting, like biopsies (e.g., 10040 for excision of lesion).

Why OBGYN Choose Stars Pro Medical Billing Services?

OB/GYN practices face a unique challenge: balancing exceptional patient care with the complexities of medical billing. Improper coding and claim errors can significantly impact a practice’s revenue cycle. This is where Stars Pro Medical Billing Services comes in. Here’s why OBGYNs partner with Stars Pro to handle their billing needs:
  1. Expertise in OB/GYN Coding and Reimbursement:

Accurate Coding for Diverse Services: Stars Pro’s team understands the nuances of OB/GYN billing, including prenatal care, deliveries (both routine and complex), and a wide range of gynecological procedures. We ensure accurate coding for all services provided, maximizing your reimbursement potential.

Staying Up-to-Date on Regulations: Medical billing regulations and coding requirements are constantly evolving. Stars Pro keeps your practice compliant with the latest guidelines, minimizing the risk of audits and maximizing revenue.

  1. Improved Revenue Cycle Management:

Faster Reimbursement: Stars Pro’s efficient processes ensure timely claim submissions and quicker turnaround times for insurance payments, leading to improved cash flow for your practice.

Reduced Denials and Rejections: Our expertise helps minimize errors in coding and claim submissions, reducing the likelihood of denials and rejections by insurance companies.

  1. Enhanced Patient Satisfaction:

Clear Communication: Outsourcing billing to Stars Pro can improve communication with patients regarding billing matters, minimizing confusion and frustration.

Streamlined Billing Processes: Efficient billing processes lead to fewer errors and faster check-out times, contributing to a more positive patient experience.

  1. Increased Efficiency and Reduced Costs:

Focus on Patient Care: By offloading billing tasks, OB/GYN physicians and staff can dedicate more time to patient interaction and core practice management activities.

Reduced Overhead Costs: Eliminate the need for hiring, training, and managing dedicated billing staff. Stars Pro helps you save on salaries, benefits, and office equipment costs.

Scalability for Growth: As your practice expands, Stars Pro can easily scale their services to accommodate your increasing billing needs. You won’t need to worry about in-house staffing limitations as your practice grows.

 

By partnering with Stars Pro Medical Billing Services, OB/GYN practices can significantly improve their operational efficiency, financial health, and patient satisfaction. This allows them to focus on what truly matters – providing high-quality care to their patients.
Explore More

FAQ! NEED HELP?

OBGYN medical billing services manage the entire billing cycle for obstetrics and gynecology practices. This includes tasks like accurate coding of prenatal care, deliveries, gynecological procedures, and diagnoses, submitting claims to insurance companies, following up on denied claims, managing patient accounts receivable, and ensuring compliance with regulations.
OBGYN coding involves unique complexities. Stars Pro specializes in OBGYN billing and understands the specific coding requirements for various women’s health services. Outsourcing allows your doctors and staff to focus on patient care while Stars Pro ensures accurate claims and maximizes reimbursements.
Certain procedures in OBGYN care, like some prenatal tests or surgeries, may require prior authorization. Stars Pro can efficiently secure these approvals, minimizing delays and ensuring patients receive timely and necessary care.
Stars Pro’s AR team manages outstanding patient balances. This includes sending patient statements, following up on delinquent accounts, and working with patients on payment plans. Efficient AR management reduces uncollected claims and improves your practice’s cash flow.
Many billing companies, like Stars Pro, offer integration with popular practice management software used in OBGYN practices. This streamlines data transfer between systems, reducing manual entry errors and improving overall efficiency.
Outsourcing practice management tasks frees up your staff to focus on patient care. Stars Pro can handle scheduling appointments, managing referrals, and ensuring accurate patient information, allowing your team to focus on delivering excellent care.
OBGYN billing regulations are subject to frequent updates. Stars Pro stays current on these changes, ensuring your practice remains compliant and avoids potential penalties.
Stars Pro should prioritize patient data security. They should be HIPAA compliant, ensuring all patient information remains confidential.
At Stars Pro, we provide regular reports on key metrics like claim submission rates, denial rates, revenue collection, and coding accuracy. This transparency allows you to track progress and measure the impact of their services on your practice’s financial health.
Beyond core billing services, Stars Pro may offer additional benefits like coding audits, denial management strategies, and performance improvement recommendations. These services can further optimize your revenue cycle management and profitability, allowing you to focus on providing the best possible care for your patients.
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CLIENT'S REVIEWS

Jeff Bogner

5/5
I have worked with Stars Pro Medical Billing for about 9 months now. They take care of my billing for my Physical/Occupational Therapy business. They are great to work with and very detailed. They have a great team. I was very impressed when I first started with them and their team approach they take and professionalism. They have always been quick to work with any problem we may be having with an insurance and work to have it resolved.

Kimberly M

5/5
The Star Pro team is great! Expedited request and the most professional staff to help a fast past growing business.

Merritt Widen, MD

5/5
We’re very happy with Stars Pro and eagerly anticipate future collaborations. Their patience and understanding have been invaluable as we grow our business together.

Catherine Antoine 

5/5
For the past three months, Stars Pro Medical Billing has been our lifesaver. They resolved every one of my pending or rejected bills. They communicate with me promptly and give thorough reports, both of which I find useful. They are excellent for your billing needs, in my opinion. Highly recommended !

Dr. Maria C Erazo

5/5
I’m very pleased with Stars Pro Medical Billing services, the transition it’s been really smooth, and Stars Pro’s team has been able to identify and solve gaps from the previous company. There is a great communication pathway and so far good results. I am very happy with my decision with my current Billing Team.

Dr. Loretta Oguonu

5/5
Stars Pro Medical Billing is a very unique company in medical billing services. Stars Pro has tremendous team players in medical billing, insurance credentialing, and clients’ insurance eligibility verification for my company Lacka Behavioral Health since we started the business with Stars Pro. Stars Pro has eased the burden of medical billing, credentialing, filling claims, and clients’ insurance eligibility for Lacka Behavioral Health from the beginning of my practice. The Stars Pro is prompt, efficient, and effective in filling medical claims and clients’ insurance eligibility. The charges for their services are reasonable and affordable. I recommend their services to healthcare providers especially providers starting a new practice.

Jessica Sullivan

5/5
Switching to Stars Pro Medical Billing was one of the best decisions I’ve made for my group mental health practice. Their team is impressively responsive! I have peace of mind knowing I can count on them to keep my billing up to date and follow up on claims, which has allowed me to focus more of my energy into my clinical work. They have kept up with my changing needs as my practice has grown and have accommodated all my requests. It’s been such a relief to know I have a reliable and knowledgeable billing team on my side!

Dr. H. Okpala

5/5
Star Pro Medical Billing Services offer excellent credentialing services, billing, and verification of eligibility. I rely on them to obtain fast legibility clearance as well as credentialing for different insurance panels. They are prompt professionals that helped build my business to what is today. I strongly recommend them to my colleagues and other start clinics knowing that you are in good hands. Keep up the good work Star Pro Medical Billing Services. 

Dr. Abordo

5/5
I am so happy and very grateful I hired Stars Pro.  I know Stars Pro team will get the account receivable lessened and will be able to collect 100% of the production per month.  Thank you very much again Peter & Stars Pro Team. Your focus and dedication is superb. I truly believe that each month will get better and better.

Greg Coya

5/5
The transparency and thoroughness of the billing process are outstanding. I love working with Stars Pro Medical Billing.

Shami Petal, MD

5/5
Stars Pro has been outstanding. I considered 2 different billing vendors prior to choosing Stars Pro, and I couldn’t be happier. Daniel sends me regular and thorough updates about every aspect of my billing. He responds to any email I send same-day with a quick answer and always follows up with a more complete analysis/answer within 24-48 hours. I am very happy with my decision with my current Billing Team.

Orthopedic Group

5/5
We are working with Stars Pro has been a big optimistic step for our practice. They quickly respond to our questions and concerns. Our billing gets processed within days and everything can be viewed online; we get daily reports from our assigned billing team. I would highly recommend Stars Pro to any practice that wants to adapt to automation, save time in the office, and improve their insurance collections!

Channel Partners

Stars Pro® Medical Billing inventive model is one of the fastest growing physician practice communities in the United States. We are dedicated to lashing change in the medical community by providing progressive, state-of-the-art solutions. Through our Channel Partnerships.

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