12,000 Charts Reviewed with 98 Percent Accuracy

Overview

The OBGYN practice, serving over 5,000 patients annually across two locations, specialized in prenatal care, high-risk deliveries, and minimally invasive gynecologic procedures. Billing inaccuracies had led to claim denials exceeding 15% of submissions, primarily due to incomplete documentation of procedures like cesarean sections and hysterectomies. These issues strained cash flow and compliance with payer requirements.

AnnexMed partnered with a mid-sized OBGYN practice to conduct a comprehensive chart audit, reviewing 12,000 patient charts and achieving 98% accuracy in coding and documentation. This initiative addressed persistent revenue leakage from documentation gaps in obstetric and gynecologic services. The effort exemplifies the expertise in revenue cycle management for specialty practices.

12,000 Charts Reviewed with 98 Percent Accuracy

Key Challenges

Persistent documentation gaps in global maternity codes (e.g., CPT 59400) and complications like preeclampsia, leading to claim denials

Undercoding of ancillary services such as ultrasounds, laboratory tests, and high-risk obstetric procedures

Elevated denial rates exceeding 15% of submissions, with reimbursement delays of 45-60 days due to absent modifiers and ICD-10 specificity

Lack of systematic audits, resulting in revenue leakage and compliance risks for a practice handling over 5,000 patients annually

How we approached it

Deployed certified coders for stratified review of 12,000 charts over three months, prioritizing high-volume encounters

Implemented customized protocols to detect trends in E/M leveling, charge capture, and documentation deficiencies

Conducted provider education sessions on best practices, emphasizing precise modifier use and complication reporting

Established real-time feedback mechanisms to drive iterative improvements without interrupting clinical operations

Our Validation Process

Conducted 10% random resampling of audited charts, confirming 98% accuracy in code assignment and charge capture.
Monitored payer denial rates, which decreased from 15% to 3%, as evidenced by three-month accounts receivable aging reports.
Secured an independent third-party review to verify compliance with HCC methodologies and OBGYN-specific coding guidelines.

Solution Impact

58%

Fewer Payer Denials

40%

Drop in Documentation Errors

98%

Chart Audit Accuracy

22%

Revenue Increase

Ready to Get Started?

Whether you need full-scale support or help with just one part of the revenue cycle, AnnexMed offers modular services tailored to your most pressing needs.

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