- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
The Stream RCM is responsible for managing entire OB/GYN billing process from eligibility to post-delivery AR collections, provides quick pre-authorizations for complex surgical procedures, uses accurate CPT/ICD-10 coding to avoid claim denials, helps new professionals get credentialed and enrolled with payers, and guarantees full compliance with Medicare, NCCI, and Medicaid policies.
OB/GYN billing requires strict adherence to global maternity package guidelines. A single code often covers prenatal, delivery, and postpartum services. Even a minor coding error can lead to claim denials and delayed reimbursements. Recent CPT updates replaced codes 49203–49205 with 49186–49190. These changes require accurate reporting of the size of excised tumors or cysts. Gynecology billing often fails due to scenarios such as problem visits, colposcopies after abnormal Pap tests, and same-day IUD placements require informed coding judgment. As an established OB/GYN billing company, our coding specialists focus exclusively on women’s health.
Our review process addresses common denial issues, including modifier 25 disputes, NCCI bundling edits, and prior authorization gaps for hysteroscopy and LEEP procedures. Stream RCM helps practices overcome these challenges with accurate, compliant, and specialty-focused billing services.
We handle billing for high-risk pregnancy services including cerclage, amniocentesis, and fetal monitoring to make sure non-global services are billed separately so you receive the reimbursement you deserve.
We manage billing for fertility treatments such as IVF, IUI, and ovulation induction to follow payer-specific authorization requirements and bundled cycle rules to help increase your collections.
Our team accurately bill pelvic floor procedures, sling surgeries, and mesh removals by using the correct CPT and ICD-10 codes to reduce denials for these complex procedures.
We support billing for gynecologic cancer surgeries, chemotherapy, and radiation treatments to make sure proper documentation, medical necessity, and timely appeals for complex claims.
Our experts bill preventive care, colposcopy, hysteroscopy, LEEP, and IUD services accurately to capture all eligible add-on codes and modifiers to help prevent lost revenue from routine visits.
Stream RCM delivers comprehensive OB/GYN medical billing services across the entire revenue cycle, with each solution meticulously engineered to address the unique financial challenges of women’s health practices.
We detect denial trends, fix causes, and make an appeal within 24 hours. Our specialists recover revenue that most other OB/GYN billing companies overlook. The result is a decreased denial rate on your side.
Our specialists monitor aging accounts, chase payers effectively, and sort out any underpayment issues. Our efforts guarantee that A/R days always stay under industry standards for gynecology practices.
We perform proactive coding and documentation audits to avoid any risks. It helps reduce chances of being audited and allows us to discover any potential charges in your GYN procedures.
Our qualified coders are proficient in CPT, ICD-10 and HCPCS codes for OB/GYN. We take care of choosing the right codes and appropriate modifiers for your billing claims.
We help with Medicare, Medicaid, and commercial payer credentialing without any difficulties. Our specialists avoid costly delays due to incomplete credentialing of providers.
We post payments, spot errors, and post them to your system accurately. You will have a good insight into your financial performance and revenue trends.
From maternity care to gynecology, we enhance your process flow to generate business opportunities that are often overlooked by your internal team.
OB/GYN billing outsourcing to us will enable your practice to lower its overhead cost. The coding specialists at our facility are aware of the details of global maternal packages, GYN services, and insurance company requirements. We are able to prevent denials of claims through the identification of any possible errors in advance and submission of clean claims that are compliant. We offer the option of scaling up or down according to your patient load without the burden of hiring or laying off employees. We stay updated on Medicare, NCCI, and state Medicaid requirements to verify that your practice remains compliant with the law and audit ready. We help you understand your financial health with clarity and confidence.
| Procedure | CPT Code | ICD-10 Code | Coding Detail |
|---|---|---|---|
| Colposcopy Review | 57452 | N87.9 | We confirm the abnormal-finding diagnosis is documented before this pairing is billed, which is where most colposcopy denials originate. |
| Biopsy Handling | 58100 | N93.9 | Our coders separate endometrial biopsy claims from the same-day visit code when payer rules require it, avoiding an unnecessary bundling denial. |
| Device Insertion | 58300 | Z30.430 | IUD placement is coded with the correct contraceptive-management diagnosis, matching state-mandated coverage rules that vary by payer and plan. |
| Hysteroscopy Claims | 58558 | N92.0 | We confirm prior authorization status before submission, since hysteroscopy is one of the most frequently authorization-blocked procedures in this specialty. |
| Screening Coding | 88175 | Z01.419 | Pap and HPV co-testing is coded against each payer's screening interval, preventing a preventable "not yet due" denial at submission. |
The use of self-collected HPV screening has been increasing in OB/GYN practices where patients can benefit from screening for cervical cancer without undergoing a pelvic examination. But for proper and accurate billing, documentation of the method of collecting the specimen, counseling of the patient, the purpose of the screening, and the plan for follow up is essential. Stream RCM can assist your OB/GYN practice through the process of evolving billing by making sure that the claims have been coded properly according to the payer rules and the current guidelines for screening. Our specialty-specific billing department will review documentation to avoid any problems related to coding and claim denial, especially when it comes to Pap test discrepancies.
Our solution integrates into the EHR or EMR software that you already have, without needing direct access and without changing your system. We use your software; we just take care of the billing for you.
OB/GYNs billing are increasingly recognizing dedicated menopause and midlife visits as an important service that their patients require. Menopause and midlife visits involve hormone therapy management, bone density testing coordination, and lengthy patient counseling. Categorizing these services is quite difficult since they don’t fall under any standard problem visits. Practices need to make sure that the amount of time spent on counseling is recorded, follow-up appointments involving hormone therapy are accounted for, and the medical necessity of some procedures is documented. Coding errors or improper documentation may result in denied claims and delays in getting paid. Our expert team assists in proper coding of menopause and midlife visits by adhering to the guidelines of various insurance companies.
Stream RCM tackles the most pressing ob/gyn medical billing obstacles with proven, provider‑friendly solutions.
Our comprehensive OB/GYN billing service will be the right choice if you want to receive all possible assistance from us. Our specific services make us a true partner in your OB/GYN billing process.
Our team verifies compliance with OB/GYN billing regulations of CMS, Medicaid, and State to avoid audit from outside parties.
We are specialized in billing related to Maternal-Fetal Medicine, Gynecologic Oncology and Laparoscopy.
We track daily, weekly and monthly reports on OB/GYN billing for your collections, denials, and A/R Days.
Our team is skilled in processing the OB/GYN claims with major payers such as Aetna, Cigna, Blue Cross Group, Medicare, and Medicaid.
We are fully compliant with HIPAA regulations to keep your patient’s protected health information safe at all times.
Global maternity billing bundles prenatal, delivery, and postpartum care into a single CPT code (e.g., 59400). We make sure correct global or split billing based on provider continuity, preventing unbundling violations
We perform root‑cause analysis, correct coding errors, and submit appeals within 24 hours. Our denial management has reduced denial rates by 40% for our GYN clients.
No, the baby’s charge, which consists of pediatrician services and NICU services, is not included in the delivery charge.
Yes, we code for conditions like pre‑eclampsia, gestational diabetes, and multiple gestations, ensuring separate reimbursement for non‑global services like fetal monitoring.
Our team monitors payer bulletins, Medicare updates, and CPT changes monthly. We adjust our coding
We optimize coding, billing, and claims management to improve collections while your providers stay focused on delivering exceptional patient care.
