Email: info@webillhealth.com | Call: +1 (425) 818 9351
Business hours: Monday to Friday, 8am to 9pm EST
Specialty revenue defense
OB/GYN Billing Services
Capturing the Full Value of Women’s Healthcare
OBGYN is uniquely vulnerable to revenue leakage because of its mix of long term "Global" maternity bundles and high ticket procedural care. When a generalist billing company manages your RCM, they often miss the technical nuances, like the precise unbundling logic for patient transitions or the specific HCPCS capture for high cost supplies, that trigger automated payer rejections. At WeBill Health, we provide the technical guardrails necessary to protect your practice from the "silent" denials that erode OBGYN margins.
The OBGYN Forensic Leakage Map
If your practice isn't seeing a 98% clean claim rate, you are likely suffering from these three technical leakage points:
The "Broken Global" & Unbundling Leakage
The technical challenge
The Global Maternity Package (59400-59622) assumes a seamless 9-month journey, but patient insurance changes, moves, or transfers of care are common. Payers frequently use automated algorithms to "bundle" everything into the delivery code even when you are clinically entitled to bill for individual prenatal visits (59425/59426) or postpartum care.
The revenue impact
Failing to accurately unbundle a single pregnancy that transfers mid term can cost a practice over $2,500 in uncollectible "gap" revenue per patient.
LARC Supply & Administration Deficit
The technical challenge
Long Acting Reversible Contraception (LARC) involves high overhead J codes (supplies like IUDs or implants) alongside procedural administration. If your billing partner isn't auditing for the simultaneous capture of the HCPCS supply code and the CPT procedure code, payers will often reimburse the "work" while denying the $800+ "cost" of the device.
The revenue impact
This leads to significant under reimbursement, where the practice effectively pays for the patient’s contraception out of pocket, creating a net loss on every insertion encounter.
Colposcopy & Biopsy Bundling Traps
The technical challenge
Diagnostic procedures in OBGYN are prime targets for "inclusive" denial logic. Payers often deny a problem oriented E/M visit performed on the same day as a colposcopy or biopsy, claiming the exam was inclusive to the procedure.
The revenue impact
This represents a massive "untapped" revenue stream, as missing the E/M reimbursement across a high volume of diagnostic visits can cost an OBGYN group 10 to 12% of its procedural revenue.
The WeBill Health Defense for OBGYN
We engineer a defense against payer attrition.
- Global Period TrackingOur coding experts monitor every maternity encounter, identifying insurance transitions or transfers before submission to ensure "Broken Global" visits are unbundled with technical precision.
- LARC Inventory IntegrityWe match supplies to procedures to ensure every high cost HCPCS code is captured alongside its administration unit to protect your inventory margins.
- Modifier-24/25 Forensic LogicOur Clinical VMAs verify documentation supports "separately identifiable" acute visits during global periods, ensuring UTI or respiratory care during pregnancy isn't gifted to the payer for free.
- Zero Leakage Procedural ReviewEvery OBGYN claim gets human pre submission review against payer rule libraries covering more than 500 payer rulesets to ensure complex modifiers are applied with technical accuracy for colposcopies and surgical assists.
Our Performance Standards
Clean claim rate on the claims we submit.
Submission guarantee on every clean claim.
A/R reduction within 90 days.
Every OBGYN claim, reviewed by an expert before it leaves
The same specialty team owns each claim from the first code to the final payment. Every claim is reviewed by an expert against your payer rules before it goes out.
You see where each one stands in your weekly velocity report.
- Eligibility verifiedCoverage and benefits confirmed before the visit.
- Encounter codedSpecialty coders capture every billable service.
- Expert reviewChecked against your payer rules before it goes out.
- Submitted within 48 hoursClean claims leave fast.
- Paid in 7 to 14 daysPayments post and denials are worked at the root.
Find out what your OBGYN practice is still owed
The Revenue Defense Audit sorts open money into what can be recovered, what is at risk and what is already gone, so you know exactly where to act first.
- Recoverable$
Underpaid and denied claims still inside the appeal window
- At risk$
Open claims approaching filing deadlines
- Past timely filing$
Claims that can no longer be appealed
Questions
OBGYN billing questions
Why do OBGYN claims get denied?
The patterns we see most often in OBGYN billing are the "Broken Global" & Unbundling Leakage, LARC Supply & Administration Deficit and Colposcopy & Biopsy Bundling Traps. Each one is broken down in the leakage map on this page, with the technical cause and the revenue impact.
How does WeBill Health prevent OBGYN denials before a claim goes out?
WeBill Health maintains internal payer rule libraries organized by specialty and by carrier, built and updated by experts who work claims in your specialty every day. Every claim receives human pre submission review against them before it goes out. When a payer changes a policy, an expert updates the library and applies it to your claims.
What does WeBill Health do differently for OBGYN practices?
Our OBGYN workflow includes global period tracking, larc inventory integrity, modifier-24/25 forensic logic and zero leakage procedural review. Coding experts who work OBGYN claims every day review each claim, and you get a dedicated US based billing manager and weekly velocity reports under the Transparency Protocol.
How is WeBill Health paid?
WeBill Health operates on a revenue share model. Our fee is a share of what we collect for you, so our outcome is tied directly to your collections performance. Your rate is set on the audit call, based on your specialty, payer mix and volume.
How quickly are claims submitted and paid?
Every clean claim is submitted within 48 hours, reimbursement velocity runs 7 to 14 days on your top payers, and our standard is a 40% reduction in A/R within 90 days. You see all of it in a weekly velocity report from your dedicated US based billing manager.
Find out what your OBGYN claims are losing
Maternity global package leakage, and services billed inside the global that should have been separate. Send four fields and we run your denial history against the payer rule libraries for your specialty and your carriers, then name each leakage point with the dollar figure attached.
Not ready? Get your Revenue Defense Score in 60 secondsRead the Denial Root Cause PlaybookSee exactly what happens after you send this
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.