OB-GYN practices face a unique blend of revenue challenges, including high patient volumes and complex payer rules. Billing teams often struggle to keep pace. Many still rely on outdated, manual systems or patched-together tools that create more inefficiency than clarity. That’s where OB-GYN billing software comes in.
Modern, integrated platforms like Rivet Health are built to streamline how you approach RCM and capture revenue. Learn how to optimize the front-end revenue cycle with OB-GYN billing software.
All medical practices face revenue cycle hurdles. However, OB-GYN practices deal with a unique set of financial headaches. That’s why they need OB-GYN billing software. The right platform can help practices overcome challenges such as:
Unlike specialties that focus primarily on acute conditions, OB-GYNs handle routine and specialized visits. Annual exams, prenatal check-ins, postpartum care, and surgical procedures all generate different billing codes. A single patient may interact with the practice dozens of times across a pregnancy, multiplying the opportunity for billing errors.
Additionally, insurance companies often bundle maternity care into packages. On the other hand, services like genetic testing and infertility treatments must be billed separately. Coders must carefully track which services fall under the packages and which do not. Mistakes often result in denied or delayed claims.
Since the implementation of the No Surprises Act, OB-GYN providers must supply patients with cost estimates before delivering out-of-network services. The practice must meet these standards, even in urgent situations. This adds another layer of administrative responsibility that older billing systems are not equipped to handle.
These challenges underscore why you need OB-GYN billing software. Without tools that streamline compliance, coding, and revenue tracking, practices risk revenue leakage and regulatory penalties.
Want to learn more about the unique billing challenges in the OB-GYN field and other healthcare specialties? Check out our guide, What Is Revenue Cycle Management in Healthcare?
Not all billing platforms are created equal. You should evaluate your options carefully and prioritize features that directly address the needs of your specialty. Here’s what to look for in OB-GYN billing software:
Your billing software must seamlessly integrate with your chosen EMR platform, such as Cerner or Epic. Manual data transfers between EHR and OB-GYN billing software are prone to errors and inefficient. A fully-integrated ecosystem will save you time and reduce the risk of these headaches so that you can access complete, accurate data.
Patients demand transparency. OB-GYN billing software that delivers upfront cost breakdowns for prenatal packages, elective procedures, and even preemptive care. Software that automates this process improves compliance with the No Surprises Act and promotes patient trust.
Your billing software must seamlessly integrate with your chosen EMR platform, such as Cerner or Epic. Manual data transfers between EHR and OB-GYN billing software are prone to errors and inefficient. A fully-integrated ecosystem will save you time and reduce the risk of these headaches so that you can access complete, accurate data.
Denied claims are common in OB-GYN care. Billing platforms should track denials, highlight trends, and automate resubmissions. Let’s say that ultrasounds are repeatedly denied due to coding errors. Your software should automatically flag the issue and suggest corrective action.
Rivet Health’s platform is designed to meet the needs of specialty practices like OB-GYN groups. Its suite of tools provides full visibility into financial performance.
Rivet’s healthcare revenue forecasting solutions can help you predict future earnings based on historical data. Use these insights to identify opportunities to grow and brace for potential declines in earning potential.
Revenue Diagnostics is one of Rivet’s most powerful tools. It delivers a holistic view of financial health by analyzing payer performance and detecting underpayments. OB-GYN practices can see if insurers are reimbursing below expected market rates for maternity packages or common surgeries.
Claim Resolution helps you manage denials more efficiently. The tool organizes, batches, and prioritizes denials, enabling your billing team to quickly resubmit and recover lost revenue.
With payer data from Rivet Health, you can negotiate better rates. Let’s say your reimbursement rates for laparoscopic procedures are below regional averages. You can use this evidence during payer negotiations to obtain better terms.
Sign up for a live or on-demand webinar to learn more about how Rivet can solve your billing headaches.
When you adopt modern billing solutions, the results include:
Learn more about how Rivet solves revenue cycle and reimbursement headaches for OBGYN clinics around the country.
There are several different OB-GYN billing software options on the market. Unfortunately, many of them simply check a box, but they lack the depth you need to reimagine your revenue cycle. Others treat the revenue cycle as an afterthought, not a primary focus.
Rivet sets itself apart in three key ways:
Download an ebook to learn more about what Rivet brings to the table and how you can use our tools to unlock the full potential of your practice.
Put a stop to revenue leakage and stop losing out on valuable payments due to inefficient denial management processes. Rivet Health’s healthcare revenue cycle management solutions are the ideal tools to help you overcome your greatest billing challenges.
Rivet Health delivers all of the features you need through Revenue Diagnostics, Claim Resolution, and payer performance tools. Rivet helps your OB-GYN practice win at RCM.
Schedule a demo today.
