Overview
This multi-location OBGYN practice serves more than 5,000 patients each year and supports everything from routine prenatal visits to high-risk pregnancies, cesarean deliveries, and minimally invasive gynecologic surgeries. As the practice continued to grow, the billing team began noticing a steady increase in claim denials. What started as isolated issues gradually became a consistent pattern, with denials crossing 15% of total submissions.
Most of these denials were not tied to the quality of care, but to how that care was being documented. Important details around procedures, pregnancy-related complications, and modifier usage were often missing or inconsistently recorded. As a result, reimbursements were delayed by several weeks, the billing team spent more time on rework, and leadership began looking for a way to gain better control over documentation accuracy and revenue leakage. That’s when the practice engaged AnnexMed for a focused chart audit.
Key Challenges
Global maternity services were often documented differently across providers, especially when complications such as preeclampsia were present, leading to frequent payer questions and denials
Ancillary services like ultrasounds, laboratory tests, and high-risk obstetric procedures were sometimes underreported, even though they were clinically appropriate
Denial rates exceeded 15%, with payments commonly delayed 45–60 days due to missing modifiers and limited ICD-10 specificity
Without a formal audit process, the practice had little visibility into where documentation gaps were occurring or how consistently providers were coding similar cases
How We Approached It
- AnnexMed assigned certified coders with OBGYN experience to review 12,000 patient charts over a three-month period, starting with high-volume encounters where the financial impact was greatest
Â
- The audit focused on identifying repeat patterns, such as missed modifiers, undercoded services, and E/M leveling inconsistencies, rather than treating each chart as a one-off issue
- Once trends were identified, we worked closely with providers through practical, case-based education sessions that used real examples from their own documentation
- To support ongoing improvement, real-time feedback loops were introduced, allowing providers and the billing team to make adjustments quickly without slowing down clinical workflows
Our Validation Process
To ensure findings were accurate and reliable, 10% of the audited charts were randomly selected and reviewed again, confirming 98% accuracy in coding and charge capture
Accounts receivable aging reports were monitored over a three-month period, showing denial rates dropping from 15% to 3% as documentation and coding consistency improved
An independent third-party review further validated that the updated coding practices aligned with OBGYN-specific guidelines and applicable HCC methodologies
Solution impact
58%
Fewer payer denials
40%
Drop in documentation errors
98%
Chart audit accuracy
22%
Revenue increaseÂ
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.
Let's get started with,
- A quick discovery call to understand your goals
- Insights on how our services align with your workflows
- Guidance on compliance, turnaround, and scaling
- Option to request case study examples
Why AnnexMed?
- 20+ Years of RCM Excellence
- HIPPA Compliance Workflows
- 50+ Specialties Supported​
- U.S. Based & Offshore Hybrid Teams​
