The OBGYN Revenue Reality
OBGYN revenue spans global obstetric care and procedure-driven gynecology. Errors in global tracking can disrupt full-package reimbursement.
- Global maternity package misclassification
- Incorrect prenatal visit tracking
- Delivery code mismatches
- Postpartum billing errors
- Ultrasound authorization gaps
- Modifier 25 and 59 misuse
- Surgical bundling discrepancies
- High-dollar AR tied to deliveries and procedures
Global Package & Modifier Governance (CCP)
- Global maternity package validation
- Prenatal visit tracking alignment
- Delivery code integrity checks
- Postpartum service validation
- Modifier governance for gynecologic procedures
Target Outcome: Reduced global billing disputes and improved first-pass acceptance.
Authorization & Coverage Controls (FIO + EAE)
- Ultrasound authorization validation
- High-risk pregnancy coverage confirmation
- Frequency and benefit monitoring
- Diagnosis-to-procedure alignment
Target Outcome: Fewer prenatal and imaging-related denials.
High-Dollar AR Optimization (AAF)
- CPT-level AR prioritization
- Payer-specific appeal workflows
- Escalation ladder for delivery-related denials
- AR > 90 monitoring by service category
Target Outcome: Faster recovery of high-value claims.
Maternity & Surgical Reimbursement Intelligence (PRL)
- Global maternity reimbursement variance
- Delivery denial clustering by payer
- Surgical bundling patterns
- Ultrasound underpayment trends
- Appeal overturn rates
Target Outcome: Visibility into recurring maternity-related revenue leakage.
Measurable Performance Targets
- 8–18% lift in net collections
- 15–30% reduction in global package disputes
- 25–40% reduction in AR > 90
- 95–98% first-pass claim acceptance
- Faster resolution of delivery-related appeals
Compliance & Infrastructure
- HIPAA-compliant workflows with BAA signed prior to PHI exchange
- Integration with major EHR platforms including Epic, Cerner, Athenahealth, NextGen, eClinicalWorks and others
- Cybersecurity oversight via Redfort Technologies
- U.S.-based nationwide operations
Are Your Global Maternity and Delivery Claims Being Reimbursed at Full Contracted Rates?
Schedule a specialized OBGYN Revenue Audit and identify how coding accuracy, documentation gaps, and denial patterns are affecting your claims, AR performance, and net collections.
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