Key Challenges in Managing an OBGYN Practice

Gynecology and obstetrics are two closely related disciplines combined into OBGYN. OB is a contraction of obstetrics. Whereas, GYN stands for gynecology. It deals with treating disorders related to the female reproductive system.

Although OBGYN has a great scope in the USA. Still, practices have been facing declining revenues since COVID-19 due to the growing scarcity of OBGYN staff, increased competition, and rising operating costs. However, due to the high demand, the specialty’s revenue grew at a compound annual growth rate (CAGR) of 0.7%, reaching $12.3 billion in 2024.

So this is the time, if you want to start your private OBGYN practice. However, there are some potential challenges you may face along the way. Our article is for you to read further, since it reveals the most frequent problems that OBGYN practices encounter and how to overcome them.

What Potential Challenges Exist?

In the dynamic healthcare sector, there are more challenges than merely dealing with patients. These challenges are discussed in detail below:

Errors in Coding

Just like the billing of every other specialty, OBGYN billing is also a complicated process. OBGYN usually deals with routine gynecological checkups, surgeries, prenatal care, labor and delivery, and postnatal care. And these processes require attention to detail and the use of the right CPT codes according to specified coding standards.

Errors in OBGYN coding can result in underpayments, delayed payments, or claim denials. Eventually, it will cause a significant revenue leakage and financial loss to your practice. So, being an OBGYN practitioner, you must take care of coding details and ensure accurate claims to remain profitable.

Overhead Expenses

Overhead cost is another major challenge for every healthcare practice. Since most medical practitioners are unaware of these financial terms. Overhead cost is an indirect cost of a practice. In simple words, it is the cost of rent, staff compensation, utilities, and medical supplies like ultrasound equipment. Such expenses usually occur due to unforeseen reasons like sudden technological changes, policy updates, or international shifts.

Hence, your practice can’t track such a petty cost. Your practice can not avoid such expenses. But they can reduce it by closely examining their financial position, identifying areas for improvement, past trends, and making future predictions.

HIPAA Compliance

There is a federal regulatory body called the “Health Insurance Portability and Accountability Act of 1996 (HIPAA)”. It has set standard rules for every healthcare practice, which also apply to OBGYN practices. It establishes data security and privacy guidelines that patients should expect from their medical providers.

Patients must get a copy of their privacy notice from covered entities, and if at all practicable, they must sign it. Practices must train employees to prevent needless privacy violations and explain how HIPAA applies to everyday operations.

Moreover, medical offices should stay updated with the latest industry standards because non-compliance can result in fines and legal problems.

Technology Implementation

Indeed, modern technology is significantly contributing to simplifying patient care and medical billing, but it requires heavy investment and advanced skill sets. Various billing tools and software boost practices’ productivity, but make things more difficult to manage and put additional administrative strain on staff.

Also, updating and maintaining billing software under industry standards requires a substantial financial investment. Some software requires you to train your employees on how to use it efficiently, in addition to the setup fees.

Inexperienced Staff

OBGYN billing requires experts to handle billing and claims filing. An inexperienced billing team will cause coding errors and inefficiencies in your practice. It will complicate the billing process and increase the probability of claim denials or payment rejections.

In addition, the fact is that most employees in healthcare practices do not possess billing expertise. Eventually, the practice has to train its employees or hire an in-house billing team. Both scenarios will contribute to overhead costs and administrative burdens on practice.

Therefore, if the practice outsources its billing process to a third-party service provider, it can avoid significant expenses and retain current staff.

Outsource to an Experienced RCM Company

In light of the above-discussed challenges faced by OBGYN practices. There is no need to worry about them. Your practice can easily navigate them by outsourcing OBGYN medical billing services to an experienced vendor.

But why is it the ultimate solution? Outsourcing is the best option because these RCM companies hire staff who possess billing & RCM expertise with personalized training for all specialty healthcare practices. Furthermore, they carefully manage all the billing operations with rapid response to constantly shifting needs and proactive measures.

If your OBGYN practice collaborates with a third-party billing company, it can concentrate on patient care instead of worrying about administrative work or service reimbursement.

Conclusion

To summarize this blog, we have addressed the most common challenges the healthcare industry imposes on OBGYN practices. However, by partnering with a third-party billing company, your practice can face these challenges. This collaboration can boost income, maintain compliance, concentrate on giving patients top-notch care, and your practice will remain at the forefront of delivering outstanding patient care.