Few specialties bill quite like obstetrics. The global maternity package — bundling antenatal visits, delivery, and postpartum care into a single payment — was designed for a patient who begins care early, stays with one practice, and delivers without complication. Real pregnancies rarely cooperate.

Where OB Revenue Slips Away

Transfers of care. When a patient moves to your practice at 28 weeks, or leaves at 32, the global code no longer applies. Practices that bill the global package anyway face recoupments; practices that fail to itemize the antepartum visits they *did* provide leave money on the table. Both errors are common.

Services outside the bundle. Non-stress tests, ultrasounds, treatment of unrelated conditions, high-risk visits beyond the routine schedule — these are separately billable, but only when documentation clearly distinguishes them from routine antenatal care. Under-documentation here is one of the largest silent revenue leaks in OB.

Gynecologic coding complexity. On the GYN side, well-woman visits combined with problem-oriented services, colposcopy and LEEP coding, and surgical global periods each carry their own modifier requirements. A missed modifier 25 or 57 turns a payable claim into a denial.

Multiple providers, one delivery. Group practices where several physicians share call must coordinate who bills the delivery and how the global is reported under the group NPI — a workflow issue as much as a coding one.

Getting Specialist Eyes on OB/GYN Claims

Because so much OB revenue hinges on specialty-specific rules, many groups have moved their revenue cycle to teams that live in this fee schedule daily. A medical billing company Sybrid MD exemplifies the model: certified coders who understand maternity bundling, denial analysts who know which payers routinely underpay deliveries, and reporting that shows each physician exactly where their collections stand.

The same logic applies to enrollment. OB/GYN groups add associates, midwives, and NPs frequently, and every uncredentialed week is unbillable. Details on managed payer enrollment are available at www.Sybridmd.com, but the principle holds regardless of vendor: start credentialing at the signed contract, not the start date.

Final Thought

Obstetric care is delivered over nine months; obstetric payment is decided in the details of how those months are documented and coded. Tighten the global package workflow and the rest of the revenue cycle tends to follow.

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