Accurate billing in obstetrics and gynecology (OB/GYN) services, especially in pregnancy care, is critical in ensuring constant cash flow for the economic survival of medical practices. EHR is a revolutionary tool that helps reduce claim denials as much as possible by making it automated, documented, and communicated across the healthcare chain.

In this article, we will focus on how the EHR Billing Services for Gynaecology can greatly minimize claims denial and streamline the financial management of pregnancy services.

Documentation Support for Proper Coding:

EHR systems allow all patients' encounters, histories, diagnoses, and treatments to be well recorded. Documentation helps ensure that the correct codes, such as the CPT, the ICD-10, and the HCPCS codes, are assigned to claims to secure their approvals.

For pregnancy-related services, this includes:

Tracking prenatal visits.

  • Recording ultrasounds and screenings.
  • Documenting the history of labor and delivery.
  • It can reduce coding errors that result from using incomplete or wrong records to generate claims and thus reduce claim denial.



Automated Claims Scrubbing

Another critical aspect of the currently used EHR systems is the possibility of automated claims analysis. 

This tool reviews claims for potential errors before submission, such as:

  • Incorrect codes.
  • Missing information.
  • Policy mismatches.

In the case of myths related to OB/GYN practices, claims scrubbing can be most effective in handling intricate billing issues such as global maternity billing to ensure that they meet the payers' necessary guidelines and help reduce rejection rates.



Real-time eligibility verification

EHR tools help with real-time eligibility verification so that the patient's insurance is current and sufficient for the expected services.

For pregnancy care, verifying coverage for prenatal visits, diagnostic tests, and delivery helps:

  • Do not fall into the trap of denials resulting from out-of-network services or non-covered services.
  • Minimise delays that are likely to result from wrong insurance information.
  • This proactive measure ensures that those providers know the coverage limitations and avoids many claim errors.



Examples of the effects of EHR systems:



Case Study 1: A Regional Women's Health Center

Challenge:

A women's health center that has more than 20 OB/GYN practitioners had high claim denial rates attributed to improper coding and insufficient documentation of maternity care. This resulted in a 15% revenue loss annually.

Solution:

The center used an enhanced EHR with functionalities for coding, claims, and compliance checks. The system incorporated particular working protocols for prenatal visits, ultrasounds, and delivery notes. These trainings aimed to familiarize the providers with the approach to follow when using EHR tools.

Outcome:

The denial rate was reduced by 40% in six months, and the center is estimated to have saved up to $ 250,000 in lost revenue. The enhanced workflow also benefited the staff as the time taken to work on claims resubmit was cut by 30%.

Case Study 2: Urban Hospital with Many Pregnant Women

Challenge:

An urban hospital with more than 10,000 maternity cases per year experienced denial of claims on eligibility and insurance coverage. It was common for staff to find out that insurance would not cover a service after it was rendered; claims were denied or paid late.

Solution:

The hospital implemented an EHR system that included real-time eligibility verification applications. It verified the insurance details before setting up appointments and identified services that would not be paid for by the patient's insurance. Further, the hospital informed patients of their coverage using patient portals.

Outcome:

The hospital reduced claim denials related to eligibility by a whopping 50% within three months. Patient satisfaction scores escalated as well from enhanced communication regarding coverage and billing. The enhanced workflow also helped billing staff attend to other chores, hence improving the organization's efficiency.



Case Study 3: Private Practice with Limited Resources

Challenge:

A small private OB/GYN practice was having a great deal of trouble managing the various codes involved in billing, particularly about global maternity services. The absence of a system of billing confuses, leading to errors, rejection of bills, and consequently low revenues.

Solution:

A cloud-based EHR solution with functionalities that include automatic charges, claims, and reports was implemented. The system was set up with an eye on how it will benefit small practices while being affordable. It also engaged an EHR billing service provider to help it.



Conclusion

EHR systems are vital in reducing claim denials for OB/GYN pregnancy services. They help automate coding and compliance checks, communication, and billing methods to ensure that reimbursements are accurate and timely.

For those interested in enhancing your practice's billing performance, outsourcing to an EHR Billing service for Gynaecology is the solution. Accept the idea of technology behind EHRs and stay on the right track – the track of improving your care for patients.

Why Partner with BillingFreedom?

Working with BillingFreedom means getting a dependable partner focused on making your revenue cycle work and reducing claim rejections. For Gynaecology, our EHR Billing Services lack coding errors and help to submit claims efficiently with proper compliance with healthcare laws. We use the latest billing technology and hire only the most experienced billing personnel to ensure your practice is financially secure.

BillingFreedom is the right choice for your practice's high-quality, fast, and effective billing services. Please contact us at info@billingfreedom.com or +1 (855) 415-3472.