Why should you outsource OBGYN medical billing services? A New Guideline for 2023 Coding

It is a common misconception that all medical billing is the same. However, this could not be further from the truth. There are many different types of medical billing, each with its own set of rules and regulations. One type of medical billing that is often misunderstood is OBGYN medical billing in OBGYN practices.

If you are an OBGYN provider, you know that medical billing can be a complex and time-consuming process. You need to submit claims to insurance companies, follow up on payments, and keep track of patient visits and procedures. The good news is that there are steps you can take to make medical billing for your OBGYN practice easier.

By understanding the basics of OBGYN medical billing and coding, you can streamline the process and get paid faster. You will also be in a better position to negotiate with insurance companies. And, if you outsource your medical billing, you can focus on providing quality patient care.

This blog provides an overview of medical billing for OBGYN providers. It covers the basics of medical coding, billing, and reimbursement. It also discusses the benefits of outsourcing medical billing.

How We Can Improve Your OBGYN Medical Billing?

OBGYN Medical Billing

A survey performed at the federal level showed that OBGYN providers make up around 5% of the general providers collectively in the United States. This was the year when the whole country had about 3000 OBGYNs serving.

Generally, when medical healthcare providers and medical practices associate with each other with the help of healthcare organizations or hospitals, they receive several benefits together. One of them is filing claims through departments as they don’t have to file claims and go through the hectic process of claim submission and billing individually. Plus, the handling of coding and claiming funnels are the responsibilities of experts who automate the billing process and expedite the revenue in a notable fashion.

This is one of the reasons why OBGYNs are stress-free compared to any other physician connected to a hospital. However, it becomes an unfortunate situation for private practices that suffer from claim rejections and payment delays due to the lack of departmental support and the challenging OBGYN billing process.

Apparently, it is not hard to understand that private practitioners and practices working independently stay behind when it comes to adhering to guidelines, laws, upgraded information, and the use of required software. And this becomes the reason for small practices and businesses to outsource their OBGYN medical billing services. With outsourcing, they become stress-free in terms of billing when all they need to provide the right code for the served diagnoses, obtain the right targets when the deadline approaches and file and submit the right type of billing form to the insurance payer.

Additionally, choosing the right OBGYN medical billing outsourcing company would be the first important task which can both alleviate the process or elevate the stress. Before we jump into discussing how a medical outsourcing credentialing company can ease your billing needs, it is a must to understand the road to having a successful OBGYN practice, what laws and guidelines are there to follow as an independent practice and some commonly used OBGYN codes for billing.

Changes in OBGYN Medical Billing Guidelines for 2023

It is not a secret that the United States healthcare department has been under fluxes over the past few years. Besides, the Patient Protection Act and Affordable Care Act were announced and regulated in 2010, but many of the legislations from the Act are still under review and many never have been implemented. According to a general rule, a law when it is signed should be implemented right away and completely penetrated into society within four years. Adhering to this, ACA passed in 2010 and should be fully functional till 2014. However, some of the rules reviewed were expected to be executed by 2020 but went away from consideration due to the pandemic.

But the technological change and many other changes did not stop them from making amendments. The administration has changed guidelines a bit more in 2010 through executive orders. Plus, economic and political changes also affect these guidelines. For all of these reasons, it becomes mandatory to remain updated by the guidelines and rules that pop in regularly, federal and state changes to the claiming procedure, required documents for claiming, and the importance of all avoiding things that can lead to denials.

Look at how the amendments in the ACA Act have affected the healthcare industry;

  • Through the ACA launch, people became more inclined towards applying for health insurance. This means that providers’ requirements and claim submissions have also been increased.
  • When OBGYN sees individual patients covered with preventive medicine, they are treated from copay-free visits. This option covers preconception care, family planning counseling, screening for HPV disease or cervical cancer, HIV screening, and annual health examination along with the violence screening from a partner.
  • The ICD-10 and CPT codes are announced in the OBGYN guidelines along with the entire private or small healthcare business to comply at any cost.

Why you should go for insurance plans (Private/Medicare/Medicaid)?

Ensure that wherever the biller belongs, either from a certified medical billing agency, hospital, or a medical organization, they need to be experts in the field. Dealing with complex issues, handling challenging insurance concerns, and making claims using codes and HIPAA compliance are routine tasks that they might be dealing with on a regular day. Make sure that the selected biller;

  • Has the information about how and where to bill the provider when he is listed in the insurance network of a patient 
  • Know where to bill when a provider is not listed in the patient insurance network
  • Know the difference between global billing and technical billing in the case of OBGYN providers
  • Has knowledge of payment options and forums
  • Have an understanding of healthcare plans (private and public) when the cost of services can be covered
  • Avoid duplicating codes and assessments which have been billed for the same patient
  • Policies and payment plan to offer out-of-pocket patients

Why billers should avoid coding errors?

Medical billers should avoid coding errors

The necessity of ICD-10 coding implementation for billers and coders has made the billing process even more challenging no matter what practice. Besides, error-prone coding becomes the common issue of claim rejections and denials.

With access to technological improvements, private patients have an understanding of ICD-10 coding and they ask about them whenever they visit. ICD-10 codes are not only stressed creating elements but they are linked with CPT codes that provide a deep understanding of diagnosis for the disease and treatment plan, however, ICD-10 codes are applied only for diagnosis.

For this reason, eliminating the risks of coding errors should be the first essential thing that billers and coders should look into while preparing bills. Also, understanding the specificity and relevancy of the codes should be on priority for a billing professional. In OBGYN, commonly used codes include;

Why Is It Important to Outsource to OBGYN billing?   

There are many reasons why outsourcing your OBGYN billing can be beneficial for your practice. When you outsource to a professional billing company, you can save time and money. The billing company will handle all of the claims and paperwork for you, so you can focus on seeing patients and running your practice.

In addition, a professional billing company will have a team of experts who are experienced in coding and billing for OBGYN services. This can help you to get accurate payments for the services you provide, and it can also help you to avoid denials and delays.

Also, outsourcing your OBGYN billing can improve your cash flow and help you to run a more efficient and effective practice. Not only this but outsourcing your billing can also help to improve your patient satisfaction levels. When patients are satisfied with their experience, they are more likely to come back and recommend your practice to others. This can lead to more business for your practice.


Overall, OBGYN billing and coding is a hectic task and without proper knowledge it is not easy to meet the required results, outsourcing your billing can be a great way to improve your practice. If you are looking for ways to improve your bottom line, patient satisfaction, and overall efficiency, then outsourcing your billing is a great option to consider.