OB Global Billing

midoricpc

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Hello

Joan Smith started her insurance coverage shortly after she found out she was pregnant. Joan saw the same doctor throughout her pregnancy, delivery and postpartum care.

The catch is, Joan's health insurance covers antepartum and postpartum care, but imposes a preexisting condition waiting period on the delivery.

Can the provider unbundle and bill the components separately so that Joan isn't responsible for the charges associated with antepartum & postpartum care? Also, where can I find the rule about this?

Thanks
Gina
 

jek521

Networker
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Our group has unbundled the global OB fee based on primary insurance coverage (policy exclusions, changes in coverage, etc.). Many years ago, we had a consultant come in for an OB-GYN coding presentation, and she advised to unbundle.

We sometimes have to provide documentation to support the services, but most claims process without difficulty.
Jen
 
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