How long does outsourcing RCM take to implement?

Our onboarding timeline is 2–4 weeks. Week 1: EHR access and workflow review. Week 2: payer rule configuration and staff training. Weeks 3–4: parallel billing before full handoff. Most practices see first payments in week 2.

Full-Cycle OB/GYN Revenue Management — From Eligibility to Collections

Q: What is RCM for OB/GYN?

OB/GYN revenue cycle management (RCM) covers the full billing lifecycle: insurance eligibility verification, prior authorization, charge capture, claims submission, payment posting, AR follow-up, denial management, and patient collections — all tailored to OB/GYN-specific payer rules and coding requirements.

Q: How much revenue is my OB/GYN practice losing?

The average OB/GYN practice loses 15–30% of potential revenue to billing inefficiencies. With 19% claim denial rates and $57.23 per denied claim, a $250K/month practice may be leaving $37,500–$75,000 per month on the table.

Q: What is a good net collection rate?

A good net collection rate (NCR) for OB/GYN is 95% or higher. NCR is calculated as total payments divided by (gross charges minus contractual adjustments). Our client average NCR is 97.6%.

8-step revenue cycle, purpose-built for OB/GYN. Real-time KPI dashboards. EHR integration with Athenahealth, eCW, and NextGen. 97.6% average net collection rate.

Free RCM Assessment →Revenue Calculator

HIPAA CompliantBAA AvailableSOC 2 Type IIAAPC CPC-OBAHIMAMGMA

Our Performance vs Industry Benchmarks

KPI Metric	Industry Target	Our Average	How It's Calculated
Net Collection Rate (NCR)	≥ 95%	97.6%	Total payments / (Gross charges − Contractual adjustments)
Clean Claim Rate	≥ 95%	98.2%	Claims paid on first submission without rework
AR Days	< 35	18.3	Average days from date of service to payment posting
Denial Rate	< 5%	1.4%	Percentage of claims denied by payers
First-Pass Acceptance Rate	≥ 95%	98.2%	Claims accepted by payer clearinghouse on first pass

8-Step OB/GYN Revenue Cycle

01✓

Eligibility Verification

Real-time insurance verification for every OB/GYN patient before the appointment. Catches expired coverage, wrong payer, and missing authorizations before they cause denials.

02📋

Prior Authorization

Automated auth requests for OB ultrasounds, GYN surgeries, robotic procedures, and high-cost diagnostic services. Auth tracking dashboard included.

03💡

Charge Capture

Same-day charge entry from EHR visit notes. Automated scrubbing for CPT/ICD-10 errors, missing modifiers, and bundling conflicts before submission.

04📤

Claims Submission

Clean claim rate of 98.2% on first submission. Electronic submission to all payers via 837P/837I EDI. Real-time submission confirmation.

05💰

Payment Posting

ERA/EOB auto-posting with exception flagging. Contractual adjustment verification against fee schedule. Underpayment identification and recovery.

06🔔

AR Follow-Up

Systematic AR follow-up on all claims at 30/60/90-day intervals. Priority queue based on dollar value and aging. No claim slips past filing deadline.

07🛡️

Denial Management

AI-powered denial detection and appeal drafting. CARC/RARC auto-analysis. 94% appeal success rate on first submission.

08👤

Patient Collections

HIPAA-compliant patient balance billing. Online payment portal. Payment plans. Compassionate collections protocols for obstetric patients.

EHR Integrations

Athenahealth

OB/GYN optimized

API Connected

eClinicalWorks

Full OB module

API Connected

NextGen Healthcare

OB/GYN billing templates

API Connected

Kareo

Independent practice focus

API Connected

DrChrono

Mobile-first OB/GYN

API Connected

RCM Solutions by Practice Size

Solo Physician

Flat-rate billing from $1,500/month. Setup in 2 weeks. No minimum volume requirements.

✓Personal billing manager
✓All payer enrollment included
✓Monthly performance report

Small Group (2–5)

Tiered pricing $2,000–$3,500/month based on volume. Group credentialing support.

✓Dedicated team of 2–3 billers
✓Group payer contracting
✓Quarterly strategy review

Large Group (6+)

Enterprise pricing $3,500–$6,000/month. Custom EHR integration and reporting.

✓Dedicated account manager
✓Custom AR dashboards
✓Monthly executive reports

Hospital-Affiliated

Custom enterprise contract. Integration with hospital billing system. Physician group RCM.

✓CBO integration support
✓Hospital payer matrix
✓Compliance reporting

OB/GYN RCM — FAQ

What is RCM for OB/GYN practices?+

OB/GYN revenue cycle management covers the complete billing lifecycle — from the first eligibility check before an antepartum visit through patient balance collection after delivery. It includes coding, claim submission, payment posting, denial management, and AR follow-up, all designed around OB/GYN-specific payer rules.

How much revenue is my OB/GYN practice losing?+

Industry data shows OB/GYN practices lose 15–30% of potential revenue to billing inefficiencies. For a $250K/month practice, that's $37,500–$75,000 per month. Our free revenue audit calculates your specific leakage based on your actual metrics.

What is a good net collection rate for OB/GYN?+

A benchmark net collection rate (NCR) for OB/GYN practices is 95% or higher. NCR is calculated as total payments ÷ (gross charges − contractual adjustments). Our client average NCR is 97.6%. Below 90% indicates significant revenue leakage.

How long does the outsourcing implementation take?+

Our standard onboarding is 2–4 weeks. Week 1: EHR read access review and payer credentialing audit. Week 2: charge entry workflows and fee schedule configuration. Weeks 3–4: parallel billing with daily reviews. Full handoff at week 4 with zero revenue gap.

“

We went from 42 AR days and 91% collection rate to 19 AR days and 97.4% collection rate in 90 days. The ROI was immediate.

Practice Administrator, Rebecca S.

5-Physician OB/GYN Group — Ohio

Start Your Free RCM Assessment

We analyze your current billing metrics, identify leakage, and show you a realistic recovery projection — in 48 hours.

Free RCM Assessment →Revenue Calculator