OB-GYN Revenue Cycle

600 deliveries a year. Are you billing every one of them correctly?

Global OB packages that get split incorrectly, IUD device codes billed without the insertion, and a Medicaid mix that quietly drags down the whole P&L. A free 15-minute assessment tells you how much each of these is costing you.

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15 minutes. Custom financial scorecard for your practice.

At a glance

Starts withFree 15-minute assessment
FormatEducational diagnostic, no cost
You getA scorecard of your top revenue leaks and where to focus
Next step/free-assessment

Is This Right for You?

This is for OB-GYN practice owners who:

Global OB billing is triggering denials because your team is not managing the bundle correctly. Antepartum, delivery, and postpartum claims are getting confused
In-office procedures are performed but the charges do not always make it onto the claim because the workflow is not set up for it
Medicaid claims have lower reimbursement but higher denial rates and your billing team does not prioritize them because the dollars are small
IUD and implant billing has specific coding requirements for the device vs the insertion that your team gets wrong regularly
Ultrasound billing, especially for OB ultrasounds, has documentation requirements that are inconsistently met

Want ongoing financial oversight? Our Fractional CFO service for OB-GYN practices may be a better fit.

What We Analyze

Where OB-GYN Practices Lose Revenue

We trace every dollar from claim submission to bank deposit in your OB-GYN practice.

01

Global OB Billing Compliance

  • Global fee split coding accuracy (antepartum/delivery/postpartum)
  • Unbundled antepartum visit billing for transfers and high-risk
  • Delivery coding accuracy (vaginal, C-section, VBAC, complications)
  • Postpartum visit billing and timing compliance
02

GYN Procedure Coding

  • Colposcopy and biopsy coding accuracy
  • IUD and implant insertion/removal billing (device + procedure)
  • LEEP and endometrial biopsy charge capture
  • E/M coding with same-day procedure billing
03

Ultrasound & Imaging Billing

  • OB ultrasound coding by trimester and indication
  • Documentation requirements for ultrasound medical necessity
  • GYN ultrasound (pelvic, transvaginal) charge capture
  • Billing for physician interpretation vs technical component
04

Payer-Specific Billing Processes

  • Medicaid-specific documentation and billing requirements
  • Commercial payer global OB fee variations
  • Prior authorization tracking for procedures and devices
  • High-risk OB billing and additional reimbursement capture

Results

What OB-GYN Practices Recover

FindingTypical Outcome
Revenue recognition fixStable monthly P&Ls enabling $295K in previously deferred investment decisions
In-office procedure capture$72,000 annual revenue recovered from charge capture corrections
Payer strategyMedicaid volume capped and commercial patient recruitment increased, improving average revenue per visit by 8%

Case Study

Real results from a practice like yours

4-physician OB-GYN practice, two locations, delivering 600 babies per year. Revenue was $3.8M but profit had dropped from 22% to 13% over four years. The physicians blamed declining reimbursements and rising malpractice costs, but the root causes were more varied.

What we found:

  • Global OB revenue recognition was causing monthly P&L swings of $80K to $120K. The accounting methodology had never been updated for the practice's volume, making financial reporting unreliable for management decisions
  • Malpractice costs were $520K annually ($130K per physician) but OB services contributed only 38% of revenue. The GYN side was effectively subsidizing OB's liability costs without any visibility
  • In-office GYN procedures (IUD insertions, colposcopies, biopsies) were performed 1,400 times per year but charges were missed on 18% of procedures. That is $72K in lost annual revenue
  • Medicaid patients (27% of volume) were generating a negative margin after fully loaded costs. The practice was losing $14 per Medicaid visit but had never calculated this

The results

Stable monthly P&Ls enabling $295K in previously deferred investment decisions

Revenue recognition fix

$72,000 annual revenue recovered from charge capture corrections

In-office procedure capture

Medicaid volume capped and commercial patient recruitment increased, improving average revenue per visit by 8%

Payer strategy

We had no idea our Medicaid patients were costing us money. Not breaking even — actually losing money on every visit. That changed how we think about our schedule.

Managing Partner, Southeast

Common Questions About Revenue Cycle Analysis for OB-GYN Practices

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