OB/GYN Billing Services in New York
New York's ob/gyn practices face unique billing challenges shaped by Empire BlueCross BlueShield's commercial rules, NY Medicaid Managed Care requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both NY payer rules and ob/gyn coding complexity.
Why New York OB/GYN Practices Need Specialized Billing
New York's healthcare market includes 90,000+ physicians, and ob/gyn practices here face a payer market dominated by Empire BlueCross BlueShield on the commercial side and NY Medicaid Managed Care on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect ob/gyn procedure coverage and medical necessity requirements. Generic billing teams without NY specific knowledge leave revenue on the table.
OB/GYN billing itself is complex. Obstetric billing uses global maternity codes (59400 vaginal, 59510 cesarean, 59610 VBAC) that bundle antepartum visits, delivery, and postpartum care. But high-risk antepartum visits, complications, and procedures outside the global package can be billed separately with the right documentation. Gynecologic billing covers office procedures (colposcopy, endometrial biopsy), surgery (hysterectomy, laparoscopy), and preventive care. When you combine this coding complexity with New York's specific payer rules, authorization requirements, and 6 NY Medicaid Managed Care managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving ob/gyn practices from New York City to Albany and across New York.
Top CPT Codes for OB/GYN in New York
Our NY coders handle these ob/gyn codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.
New York Payer Challenges for OB/GYN
Every NY payer has specific rules for ob/gyn claims. Here's how we navigate them.
Empire BlueCross BlueShield OB/GYN Claims
Empire BlueCross BlueShield processes the largest share of New York commercial ob/gyn claims. We know their NY specific fee schedules, prior authorization requirements for ob/gyn procedures, and their appeal timelines when claims are denied. The OB global includes 13 antepartum visits, delivery, and postpartum. Unbundling errors in either direction cause denials.
NY Medicaid Managed Care OB/GYN Billing
NY Medicaid Managed Care routes ob/gyn patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 more. Each MCO has its own ob/gyn authorization and billing rules that we manage.
Medicare (Novitas Solutions) OB/GYN Coverage
Novitas Solutions processes Medicare ob/gyn claims in New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around high-risk add-ons to prevent medical necessity denials.
Denial Prevention for New York OB/GYN
Common ob/gyn denials in New York include antepartum visit billed outside global without documentation and high-risk condition not coded as secondary diagnosis. Our team catches these issues before submission and appeals aggressively with NY payer-specific documentation when denials occur.
Get Expert OB/GYN Billing in New York
Free billing assessment for your NY ob/gyn practice. See where revenue is leaking.
What We Handle for New York OB/GYN Practices
New York OB/GYN Billing Cost Comparison
Hiring an in-house biller with ob/gyn expertise in New York costs $45K-$62K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified ob/gyn coders and NY payer specialists for a fraction of that cost.
$45K-$62K
In-House Biller Salary
+ benefits, software, space
2.49%
Go Medical Billing Rate
Full team, all services included
60-80%
Typical Cost Reduction
With better results
Related Pages
Explore our New York and ob/gyn billing resources.
Frequently Asked Questions
Fix Your New York OB/GYN Billing
Call 888-701-6090 for a free billing assessment specific to your NY ob/gyn practice. We'll show you where revenue is leaking and how to fix it.