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Showing posts with the label Global Maternity Bundle

Are AI Scribe Notes Triggering Medicare Advantage Denials in Primary Care?

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AI scribes are becoming increasingly common in primary care practices. By capturing conversations and converting them into clinical notes, these tools can reduce documentation time and help physicians spend more time with patients. But faster documentation does not automatically mean cleaner claims. If AI-generated notes do not accurately reflect the services provided, important clinical details are missing, or the final note does not support the codes submitted, Medicare Advantage claims may face additional scrutiny, denials, or payment delays. For primary care practices, the goal should not be to avoid AI scribes. It is to make sure AI-assisted documentation is reviewed and supports accurate coding and billing. How AI Scribe Notes Can Affect Claims AI scribes generate documentation from conversations between providers and patients. The output may include the patient's history, assessment, plan, and other clinical details. However, an AI-generated note can contain omissions, inacc...

How Can Providers Bill Outside the Global Maternity Bundle Without Triggering Denials?

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Providers can bill outside the global maternity bundle without triggering denials by correctly identifying non-global services, using accurate documentation, and applying proper coding and modifiers. OB/GYN billing is highly regulated, and incorrect handling of services outside the global package often results in denied or delayed claims. Understanding what qualifies as billable outside the bundle is essential for protecting revenue. What Is Included in the Global Maternity Bundle? The global maternity bundle typically includes routine antepartum care, delivery services, and postpartum care within a defined period. Services generally included are: Routine prenatal visits Vaginal or cesarean delivery Postpartum visits within the global period Billing any included service separately can lead to claim denials . Which Services Can Be Billed Outside the Global Maternity Bundle? Certain services are not included in the global maternity bundle and may be billed separate...