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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.
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 Health 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.