OB-GYN Billing

Why OB-GYN Practices Face Unique RCM Challenges

OB-GYN practices often face significant challenges in Revenue Cycle Management (RCM), ranging from coding complexities for procedures like laparoscopic surgeries to denial management for high-volume patient care. According to recent studies, over 30% of OB-GYN claims are denied due to coding inaccuracies or inadequate documentation. With healthcare RCM expected to face even greater challenges in 2025, including evolving payer rules and increased patient responsibility, efficient management has never been more crucial.

At Scionis RCM, we specialize in addressing the specific needs of OB-GYN practices, ensuring your revenue streams remain uninterrupted while you focus on patient care.

How Scionis RCM Transforms OB-GYN Revenue Cycle Management

1. 1. Comprehensive Denial Management: OB-GYN practices experience denial rates of up to 15%, delaying payments and impacting cash flow. Scionis RCM's expert RCM team boasts a 90% success rate in overturning denials within 30 days, ensuring rapid reimbursements.
2. 2. Advanced Coding and Documentation Support: Procedural complexity and evolving ICD-10 codes result in errors that reduce claim accuracy. Our certified coders specialize in OB-GYN-specific codes such as Hysteroscopies (CPT 58558) and Routine Prenatal Care (CPT 59400), minimizing rejections and audits.
3. 3. Predictive Analytics for Financial Forecasting: A lack of transparency in financial health hampers growth. Using cutting-edge AI tools, Scionis RCM provides actionable insights, helping practices forecast revenue and identify underperforming areas.
4. 4. Offshore and Onshore Support Models: For practices seeking cost-effective solutions, our offshore RCM services offer the same quality at reduced rates. Alternatively, our onshore RCM services in the U.S. provide localized expertise for state-specific regulations and payer requirements.

The Scionis RCM Advantage: Why We’re the Best Choice for OB-GYN Practices

• • Experience Across 50 States: From California to Florida, our team understands the nuances of state-specific billing rules.
• • Proven Track Record: Clients report a 30% increase in net collections and a 50% reduction in A/R days after partnering with Scionis RCM.
• • Transparent Communication: We offer 24/7 support with real-time updates on claim statuses, making our service seamless and stress-free.
• • Data Security: Compliance with HIPAA ensures your patient data remains secure.

RCM Challenges in 2024-2025: How Scionis RCM Addresses Them

• • Denials and Reimbursements: Data shows that denials accounted for 25% of delayed claims in 2024. Our robust denial management system prevents this through thorough claim scrubbing and payer follow-ups.
• • Increasing Patient Responsibility: As high-deductible health plans become the norm, collecting patient payments has become a significant burden. We offer tools like automated patient reminders and flexible payment plans to simplify collections.
• • Staffing Shortages: By partnering with Scionis RCM, you gain access to a scalable team of RCM experts without the overhead costs of maintaining in-house staff.

Case Study: Transforming an OB-GYN Practice in Texas

Challenge: A mid-sized OB-GYN practice faced a 35% denial rate, primarily due to incorrect coding for laparoscopic procedures.
Solution: Scionis RCM deployed a team of certified coders and denial experts, who reduced the denial rate to 7% within 60 days. By optimizing their RCM workflow, the practice saw a 40% increase in collections and expanded their patient base without financial strain.