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Case study · OB/GYN
$300K more in annualized collections for a 4 provider OB/GYN practice
Denials were running at 14% and $260K sat in A/R past 90 days. Patients were paying only 71% of what they owed. Ninety days after WeBill Health took over the revenue cycle, every one of those numbers had moved.
The practice
Care was delivered. Payment was not keeping up.
A four provider OB/GYN practice where a single pregnancy can span nine months, two insurance plans and several services outside the global package. Collections were lost in the handoffs.
| Specialty | OB/GYN |
|---|---|
| Providers | 4 |
| Annual collections | $1.8M, about $150K a month |
What we found in the audit
14% of claims denied
Too many claims came back unpaid, with the same denials repeating month after month.
$260K stuck past 90 days
Earned money was sitting in aging A/R with no one working it by payer or by filing deadline.
90% clean claim rate
Too many claims needed rework before a payer would even process them.
71% of patient balances collected
Copays and balances were left behind at checkout and never recovered.
What WeBill Health changed
Six fixes before the visit, in the coding and after submission
Every claim received human pre submission review by OB/GYN coding experts, checked against our payer rule libraries for each carrier this practice bills.
Confirm coverage for the whole pregnancy
- Eligibility verified at confirmation of pregnancy and rechecked through delivery
- Authorizations secured for procedures and imaging that need them
Bill the global package correctly
- Global obstetric billing reviewed so each package is billed once and complete
- Bundled service review to find services billed separately that belong in the package, and services outside it that were never billed
Recover what slipped
- Every denial appealed and defended with the payer until paid
- Aging A/R recovered in priority order by payer and by age
90 day results
Before and after WeBill Health
Denial rate
Lower is betterClean claim rate
Higher is betterA/R over 90 days
Lower is betterPatient balances collected
Higher is betterMonthly collections
Higher is betterEvery bar starts at zero. Figures come from the practice's own billing reports, comparing the baseline month with month three.
Where the $300K comes from
An extra $25K collected every month
Monthly collections rose from $150K to $175K by day 90. Held for a full year, that is $300K the practice collects on care it was already delivering.
The gain came from specialty specific coding and fewer days in A/R. Fewer claims were denied, and balances that had aged past 90 days were finally collected.
Net return is the annualized increase in collections, minus the annual WeBill Health fee, divided by that fee. It is calculated before any savings from the practice's previous billing arrangement.
The math
Where the $25,000 a month came from
Estimated breakdown, built from OB/GYN billing benchmarks and 2026 Medicare rates, tied to this practice's measured before and after figures. Each line is a claim count multiplied by what those claims pay. A/R cleared from the old backlog is reported separately and is not part of this monthly gain.
| Change | Added a month |
|---|---|
| Denials stopped before they happenedAbout 1,282 claims a month at an average of $117 collected. Cutting the denial rate from 14% to 5% means 115 fewer denials a month. Before, about half of denials were never reworked, so 58 of those claims are now paid that were not. | $6,786 |
| Patient balances collectedPatients owe about $18,000 a month in copays, deductibles and coinsurance. Collection rose from 71% to 89%. | $3,240 |
| High risk antepartum visits billed outside the globalAntepartum visits beyond the routine 13, billed as E/M with modifier 25 and the high risk diagnosis, 92 a month at about $89 each. | $8,188 |
| Underpaid claims recovered117 claims a month paid below the contracted rate, short by an average of $58, now appealed and recovered. | $6,786 |
| Added collections a month at day 90 | $25,000 |
Prior authorization moved to WeBill Health as well. The AMA 2025 survey puts that work at 13 hours a week per physician, or about 52 hours a week for 4 providers. At the national median wage for medical administrative staff ($45,930 a year, BLS May 2025) plus benefits, that workload is worth about $85,298 a year in staff time.
Codes and conditions
The claims behind these numbers
| Visit type | Codes and rules | Typical conditions (ICD 10) |
|---|---|---|
| Global obstetric care | 59400 or 59510 only when one practice provided all care; split to 59425 or 59426 plus 59409 or 59410 on a transfer | Supervision of normal first pregnancy Z34.01 |
| High risk antepartum visits | E/M with modifier 25 and the high risk diagnosis, billed outside the global | Supervision of elderly multigravida, third trimester O09.523 |
| Ultrasound and procedures outside the global | 76805 OB ultrasound, 57454 colposcopy with biopsy | ASC US on cervical cytology R87.610 |
| Contraception and gynecology | 58300 IUD insertion, 99213 problem visits, prior authorization for hysterectomy | IUD insertion Z30.430; excessive menstruation N92.0 |
What it costs
The 5% fee against the cost of doing this in house
This practice's WeBill Health rate is 5% of collections. At $175,000 a month that is $105,000 a year. Here is what the same work costs a 4 provider practice that staffs it in house, before software and clearinghouse fees.
| Item | Per year |
|---|---|
| In house billing staff1.5 billers for 4 providers (MGMA: about one per two to three providers) at $73,160 each, the BLS median of $51,140 plus benefits | $109,740 |
| Prior authorization staff time13 hours a week per physician (AMA 2025), 52 hours a week, at the BLS median for medical administrative staff plus benefits | $85,298 |
| In house cost | $195,038 |
| WeBill Health fee, 5% of collections | $105,000 |
| Saved against in house staffing | $90,038 |
| Added collections a year | $300,000 |
| Better off each year with WeBill Health | $390,038 |
What other OB/GYN practices can take from this
Three OB/GYN billing gaps worth checking this week
Bill global obstetric care once, at the end
Global codes such as 59400 and 59510 cover routine prenatal visits, delivery and postpartum care in one claim. Billing prenatal visits separately invites denials.
Split the package when insurance changes mid pregnancy
When a patient changes payers or practices during pregnancy, the global code no longer fits. Antepartum care is billed with its own codes for each payer.
Bill what falls outside the package
Some services, such as certain ultrasounds and visits for unrelated problems, are not part of the global package and can be billed separately when documented.
Your practice next
Find out what your OB/GYN practice is leaving uncollected
The Revenue Defense Audit reviews your denials, aging A/R and patient collections the same way we did here. You get a written report that ranks the fixes by dollars at stake. We reply within one business day.
Questions
About this case study
How fast did the results appear?
Every figure on this page was measured at day 90, comparing the practice's baseline month with its third month on WeBill Health.
Why is the practice not named?
We protect our clients' privacy. The figures come from the practice's own billing reports.
What drove the biggest change?
The denial rate. Cutting denials from 14% to 5% meant far more claims were paid the first time, which lifted monthly collections and stopped new balances from piling up in aging A/R.
Does WeBill Health work with other OB/GYN practices?
Yes. OB/GYN sits in our Procedure and Surgical billing group. Every account is handled by coding experts who work OB/GYN claims every day.
We bill inside the system you already use
Our billers and coders work every day in the five EHR, EMR and practice management systems most used in OB/GYN. You keep your software, and we take over the billing inside it.
EHR, EMR and practice management
- EPEpic
- ECeClinicalWorks
- ATathenaOne
- NENextGen Healthcare
- GRGreenway Health
Clearinghouses
- OPOptum
- AVAvaility
- WAWaystar
- TRTriZetto
- OFOffice Ally
Using a system that is not listed here? Tell us on the audit call. Product names are trademarks of their owners and appear here only to show the systems we work in. No partnership or endorsement is implied.