Obstetric billing is unusual because a single code can cover nine months of care. Antepartum visits, delivery, and postpartum care roll into one global package, which makes it very easy to deliver services that never get billed.

Gynecology has its own problem, where problem visits get folded into preventive exams and the practice collects for one when it earned both.

A patient moves, changes insurance, or transfers practices. Now nobody bills the global. Antepartum visits get reported by count, and if the transfer is not tracked carefully, some of that care is never billed at all.

Problem visits unrelated to pregnancy, additional ultrasounds, non stress tests, and management of conditions like gestational diabetes are separately billable. Practices frequently absorb them because the patient is pregnant and it feels like it should be included.

Additional visits beyond the standard schedule are reportable when documentation supports medical necessity. That documentation usually exists and the billing usually does not follow it.

A well woman exam that also addresses a new complaint supports both a preventive code and a problem E and M with modifier 25. This is one of the most commonly missed opportunities in gynecology.

• Charge entry and coding review against your documentation
• Claim submission and clearinghouse rejection management
• Denial classification by reason, source, and cause with actionable feedback to your team
• Accounts receivable follow up and payer escalation
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You keep your EHR and your workflow. We integrate with PrognoCIS, athenahealth, AdvancedMD, gGastro, Sevocity, eClinicalWorks, and Open Practice, among others.

Stanley Smith, CPA, refers his clients to Medicus and named an OBGYN practice among them, citing service quality and attention to detail.

We work with solo practitioners and multi physician women’s health groups, and we handle both the obstetric and gynecologic sides of the practice.

Cyndi Walker founded Medicus after decades inside medical billing, and holds Certified Medical Coder and Certified Healthcare Business Consultant credentials. Medicus carries corporate accreditation from HBMA and the National Society of Certified Healthcare Business Consultants.

We are not a call center and we do not route your account offshore. You get people who know your specialty and answer the phone.

Not as a global. You report the antepartum care you provided by visit count, plus delivery and postpartum if you provide them. The tracking is what practices get wrong, since partial care is easy to lose track of across a long pregnancy.

Yes, when it is unrelated to the pregnancy or represents management beyond routine antepartum care. Gestational diabetes management and hypertension monitoring are common examples that frequently go unbilled.

Both are reportable when the problem is significant and separately identifiable, with modifier 25 on the problem E and M. This is one of the largest recurring misses in gynecology.

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Schedule a billing review and we will tell you where the revenue is going.