Ambulatory Surgery Center
Billing Support
Improve ASC revenue performance with accurate coding, clean claims, faster reimbursements, denial management, payer follow-up, and compliance-focused billing support designed for ambulatory surgery centers.
- Clean Claims
- Faster Payments
- Denial Control
- Coding Accuracy
OB/GYN Billing Services for Obstetrics and Gynecology Practices
A single global maternity claim can carry months of prenatal care, a delivery, and postpartum follow-up, and one missed modifier, a wrong trimester-specific diagnosis code, or a service billed inside a bundle it should have been billed beside can hold thousands of dollars in A/R or trigger an outright denial. OB/GYN is one of the harder specialties to bill correctly, and general billing teams routinely under-collect on it. OB/GYN billing services from Advanced IT and Healthcare Solutions are built around the coding, payer, and revenue-cycle realities specific to obstetrics and gynecology.
Why OB/GYN Billing Is More Complex Than General Medical Billing
OB/GYN combines obstetrics, gynecology, surgical procedures, diagnostics, and family planning under one practice, each with its own coding logic. Maternity care is reimbursed as a bundled global package billed once, after delivery, unlike the visit-by-visit billing most specialties use, so a biller has to track an entire pregnancy and know which services fall outside the bundle. Payer rules for antepartum and postpartum care, vaginal versus cesarean coding, trimester-specific ICD-10 codes, and frequent policy updates all raise the denial risk, which is exactly why generalist billing under-performs here.
Global Maternity Package Billing
The global OB package bundles routine antepartum care (roughly 13 prenatal visits), labor and delivery management, and postpartum care into one reimbursement for an uncomplicated pregnancy, billed after delivery when the same provider or group (same tax ID) handles all three phases (AAPC; payer policies, 2025).
Common Global CPT Coding Categories
Included in Package
Billed Separately
The global package covers routine prenatal visits, admission, management of uncomplicated labor, the delivery itself, repair of minor lacerations, and routine postpartum care, billed under one code after delivery. Ultrasounds, lab work, non-stress tests, and visits for genuine complications are billed separately.
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Global Maternity Package Billing
The global OB package bundles routine antepartum care (roughly 13 prenatal visits), labor and delivery management, and postpartum care into one reimbursement for an uncomplicated pregnancy, billed after delivery when the same provider or group (same tax ID) handles all three phases (AAPC; payer policies, 2025).
Billing a problem E/M alongside a preventive well-woman visit (99381–99397) or alongside a procedure such as colposcopy or IUD insertion without documentation that clearly supports a separate, significant service. Payers assume the visit is included unless the note proves otherwise.
Billing a routine prenatal visit separately when it belongs inside the global package, or billing the global code on the same day as a routine visit.
Using a first-trimester gestational diabetes code (O24.x) for a patient at 30 weeks. Obstetric diagnosis codes are trimester-specific and must match gestational age.
Ultrasounds and Pap/HPV testing denied because the diagnosis does not justify medical necessity, or a screening ICD-10 is used for a diagnostic visit.
Eligibility and prior-authorization gaps. Industry surveys identify missing or inaccurate data, authorizations, and incomplete patient information as the leading denial drivers.
OB/GYN billing layers global-package rules, payer-specific antepartum and postpartum policies, trimester-specific diagnosis coding, and heavy modifier use on top of normal claims work. Each adds a failure point, so practices without specialty-trained billers tend to see higher denial and underpayment rates.
Global Maternity Package Billing
Key Modifiers Used in OB/GYN Billing
Documents that the E/M was significant and separately identifiable from any procedure performed the same day.
Two procedures that would normally be bundled under NCCI edits are actually distinct and separately reportable.
Used when interpreting hospital-owned imaging (e.g., reading an ultrasound performed on hospital equipment).
Applied to secondary procedures performed in the same session. Medicare and most commercial payers apply a reduction on secondary procedures.
Applied for surgical assistant services when the procedure qualifies. Medicare requires specialty-specific assistant eligibility by CPT code.
A/R Aging Buckets — Monitored Weekly
Fix the front end and close the loop. Verify eligibility and authorizations before the visit, scrub claims for modifier and diagnosis-linkage errors before submission, and analyze denial reason codes monthly to correct the root cause. A specialty billing partner runs this without adding payroll.
Prior Authorization and Eligibility Verification
A large share of OB/GYN denials originate before a claim is ever submitted, so coverage is verified in real time and authorizations are secured ahead of services such as imaging, surgical procedures, and certain diagnostics. For maternity patients, confirming benefits early also lets the front desk give accurate cost estimates and reduces surprise-billing friction. Verifying eligibility before screening and diagnostic services keeps Pap, HPV, and ultrasound claims from being denied for coverage or medical-necessity reasons.
Credentialing and Payer Enrollment for OB/GYN Providers
Enrollment and credentialing delays quietly stall revenue: an OB/GYN who sees patients before payer enrollment is complete generates claims that cannot be paid. Advanced IT and Healthcare Solutions supports provider enrollment, CAQH maintenance, and re-credentialing so new and existing providers stay billable across commercial, Medicare, and Medicaid plans.
OB/GYN Billing Reports and Revenue Cycle Transparency
Outsourced billing should make a practice's numbers clearer, not hide them. Monthly reporting includes clean claim and first-pass acceptance rates, denial rate by payer and reason code, days in A/R and aging buckets, collections and net collection rate, and the status of submitted, pending, and appealed claims. The point is a revenue cycle the practice owner can read at a glance and question line by line.
Switching to an OB/GYN Billing Company
The most common reason practices delay outsourcing is fear of disruption to cash flow. A structured transition limits that risk: existing A/R is reviewed and worked in parallel so older claims are not abandoned, payer logins and clearinghouse connections are mapped, the practice management system and EHR are integrated, and a cutover date is set so no claims fall through the gap. A typical onboarding runs a few weeks depending on payer mix and system access, with legacy A/R worked alongside new claims.
How Advanced IT and Healthcare Solutions Can Help
Advanced IT and Healthcare Solutions supports OB/GYN practices across the full revenue cycle: charge entry and OB/GYN-specific coding, global maternity package and itemized care billing, claim scrubbing and submission, denial management and appeals, A/R follow-up, prior authorization and eligibility verification, credentialing and payer enrollment, payment posting, and monthly KPI reporting. The team helps practices identify billing gaps, reduce preventable denials, improve claim follow-up, and build a more consistent revenue cycle. We do not promise guaranteed results, payer behavior and case mix vary, but we do commit to a defined, transparent process and reporting you can verify against your own books.