Top OB/GYN Billing Challenges and How Outsourced Experts Solve Them
OB/GYN medical billing is among the most complex areas in healthcare revenue cycle management. From global obstetric packages to payer-specific requirements and frequent coding updates, OB/GYN billing can easily overwhelm in-house teams.
That’s why many obstetrics and gynecology practices partner with Everest A/R Management Group, Inc. — a trusted name in medical billing and revenue cycle management services. Our experts help providers streamline operations, eliminate errors, and maximize reimbursements.
Let’s explore the top OB/GYN billing challenges and how Everest A/R Management Group delivers practical, results-driven solutions.
Complex Global OB Packages
Challenge:
Bundling and billing for global OB packages — covering prenatal visits, delivery, and postpartum care — can be confusing. Errors in splitting or bundling services often cause revenue loss or payer denials.
Everest Solution:
Our certified coders specialize in OB CPT codes (59400, 59409, 59510, 59610, etc.) and payer-specific billing rules. We ensure accurate bundling for global maternity care and proper billing for complications, ultrasounds, or non-routine services outside the global period.
Frequent Coding and Documentation Errors
Challenge:
Frequent CPT and ICD-10 code updates for gynecologic exams, maternity, and procedures often result in coding mistakes and compliance risks.
Everest Solution:
Everest’s coding professionals use AI-driven billing tools and manual audits to validate every claim before submission. Our team stays updated on all ICD-10 and CPT revisions, ensuring documentation accuracy and 100% compliance with payer requirements.
Managing Multiple Payer Policies
Challenge:
Every insurer has different rules for prenatal visits, preventive screenings, and contraceptive procedures. Keeping up with these variations is time-consuming for in-house staff.
Everest Solution:
We maintain a comprehensive database of payer-specific policies and use real-time eligibility verification tools. Our process ensures claims meet all payer requirements, minimizing rejections and accelerating reimbursements.
Denials and Delayed Reimbursements
Challenge:
Denied claims and delayed payments directly affect cash flow and revenue predictability.
Everest Solution:
Everest A/R Management Group’s denial management specialists analyze every denial trend, file timely appeals, and implement corrective action plans. We’ve helped OB/GYN practices reduce denials by up to 40% and achieve faster, cleaner claim approvals.
Time-Consuming Administrative Work
Challenge:
Balancing billing with patient care and administrative duties can stretch staff thin, reducing efficiency and patient satisfaction.
Everest Solution:
By outsourcing billing to Everest, practices free up valuable time and resources. We manage claims submission, payment posting, A/R follow-up, and reporting, allowing your staff to focus entirely on patient care.
Compliance and Audit Risks
Challenge:
OB/GYN billing involves sensitive coding areas related to women’s health, reproductive care, and preventive services. Non-compliance can trigger audits and penalties.
Everest Solution:
Our billing team strictly adheres to HIPAA, OIG, and CMS regulations. We conduct routine compliance audits and provide transparent reporting — ensuring your practice remains audit-ready and fully compliant.
Lack of Revenue Insights
Challenge:
Without clear visibility into collections, payer performance, and claim aging, practices struggle to make informed financial decisions.
Everest Solution:
Everest offers real-time revenue cycle analytics and dashboards. We deliver detailed reports on key metrics like denial trends, payer mix, days in A/R, and collection ratios — empowering practices with data-driven financial control.
Why Choose Everest A/R Management Group, Inc.
20+ years of experience in OB/GYN billing and RCM
Certified medical coders (CPC, CPB) and compliance specialists
Advanced billing software and AI-enabled claim tracking
Dedicated account managers for personalized service
Proven track record of increasing revenue and reducing denials
Conclusion
OB/GYN billing requires precision, compliance, and constant payer awareness. Partnering with Everest A/R Management Group, Inc. ensures your practice’s financial health is in expert hands. From coding accuracy to faster reimbursements, we simplify the billing process so you can focus on what matters most — patient care.
📞 Contact Everest A/R Management Group, Inc. today to discover how our OB/GYN billing services can improve your collections, compliance, and cash flow.
