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Showing posts with the label OBGYN Prior Authorization

How OBGYN Practices Can Prepare for the 2027 Maternity Billing Changes

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The 2027 maternity billing changes will significantly alter how OBGYN practices report maternity care. Beginning January 1, 2027 , the CPT maternity care structure will move away from the traditional global model toward more detailed reporting across four phases: antepartum care, labor management, delivery, and postpartum care . The American Medical Association (AMA) has confirmed that 17 existing codes will be deleted, 12 new codes will be added, and six codes will be revised. For OBGYN practices, this is not simply a coding update. It can affect documentation, EHR workflows, charge capture, claims submission, payer contracts, reimbursement, AR, and denial management. Practices that begin preparing now will have more time to test their systems, train staff, review payer requirements, and identify potential revenue risks. For a broader explanation of the upcoming changes, see What Is the 2027 Maternity Billing Change and How Should OBGYN Practices Prepare? . Understand What Is Chan...
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OBGYN Prior Authorization Delays Are Increasing Payment Delays — Here's the Solution

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  Prior authorization has become one of the biggest administrative challenges for OBGYN practices in 2026. As commercial insurers and Medicare Advantage plans continue expanding authorization requirements, many providers are experiencing delayed treatments, claim denials, slower reimbursements, and growing accounts receivable (AR). Even when services are medically necessary, missing or incorrect prior authorization can prevent timely payment and negatively impact practice cash flow. OBGYN practices routinely provide services that require prior authorization, including advanced imaging, surgical procedures, infertility treatments, high-risk pregnancy care, outpatient procedures, and certain medications. Managing these requirements internally can consume valuable staff time while increasing the risk of billing errors and reimbursement delays. This is why more providers are relying on specialized OBGYN billing services , medical billing services , and comprehensive RCM services to st...
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