The Power of Comprehensive RCM Services in Women's Health & Surgery Clinic's Success Story
Outsourcing medical billing and credentials to **Code Credentia** allowed Women's Health & Surgery Clinicto eliminate critical billing administrative burdens, recover aged claims, and drive substantial growth. Below, we detail the challenge face by the practice and the direct solution delivered by Code Credentia.
The Challenge
Women's Health & Surgery Clinic lost thousands in revenue each month due to administrative coding errors in global OB care packages (antepartum, delivery, and postpartum care) and incorrect modifier usage for diagnostic colposcopies, biopsies, and ultrasounds done on the same day.
The Solution
Code Credentia's certified OB/GYN coders overhauled the clinic's encounter forms, implementing a dual-validation check for global package splits and same-day procedures. We also implemented prior-authorization verification workflows for elective gynecological surgeries.
Through the Partnership with Code Credentia, Women's Health & Surgery Clinic Achieved Remarkable Results:
- ✓Slashed surgical and diagnostic claim denials from 14% to under 2.1% in 90 days.
- ✓Eliminated unpaid prenatal splits by tracking patient transfers and insurers dynamically.
- ✓Reduced billing administrative tasks for clinical nurses by 20 hours per week.