OB/GYN RCM software built around your EHR
Connect coverage and benefit checks, authorization evidence, clinical notes, coding review, claims, denials, payments, and patient outreach across obstetric and gynecology workflows. Your clinical team can keep working in its EHR while revenue-cycle tasks move through controlled queues.
OB/GYN RCM software modules across the revenue cycle
Use the modules you need, keep other steps in your current systems, and define where QuickIntell should automate, request approval, or simply notify your team.
Eligibility Verification
Checks active coverage and returns benefit details so staff can review copays, deductibles, and service-specific coverage before the visit.
Prior Authorization
Combines patient, payer, service, and clinical data in one worklist for submission, status tracking, renewals, and approval evidence.
AI Medical Scribe
Drafts structured encounter notes for provider review and attestation, then passes approved clinical context to downstream coding.
Medical Coding
Suggests CPT, HCPCS, ICD-10, and modifiers, flags documentation questions, and keeps coders in control of final decisions.
Claims
Builds and scrubs claims with eligibility, authorization, and coding context before submission, then tracks payer acknowledgments and status.
Denial Prevention
Applies pre-submission checks for documentation, coverage, authorization, coding, and payer rules, with findings routed back for review.
Denial Management
Groups denied and partially denied claims by payer reason and supporting evidence so the assigned team can choose the next action.
Payment Posting
Reads ERA and EOB data, matches remittance lines, applies configured posting rules, and sends unmatched items to an exception queue.
QuickVoice
Supports appointment reminders and outbound patient follow-up while keeping call history and campaign activity available to operations teams.
EHR Integration
Maps patients, appointments, encounters, notes, coverage, claims, and payments through the available connection, with conflicts sent for human resolution.
Why OB/GYN revenue cycle management is hard to keep connected
A single OB/GYN episode can move through registration, clinical, coding, billing, and payer teams. When evidence or status stays in one system, the next team often discovers the gap too late.
Maternity episode complexity: Benefit periods, patient responsibility, global maternity package context, and separately reviewed services can span months of care.
Authorization dependencies: Prenatal genetic testing, ultrasound frequency, medication, and gynecologic procedures can require different evidence by payer and plan.
Clinical-to-billing handoffs: Notes must support the service, diagnosis, medical necessity, and modifiers before coding and claim release decisions are made.
Patient and payer follow-up: Schedule changes, missing information, authorization status, claim responses, and denials create work across separate queues and teams.
One maternity episode, many administrative handoffs
Keep benefit findings, authorization evidence, documentation, coding decisions, and claim status tied to the same episode so each reviewer can see what happened upstream.
See the maternity benefit and authorization trackerFrom scheduled visit to posted payment
QuickIntell passes context forward instead of treating each OB/GYN billing task as a separate automation. Your team chooses which steps run, pause for approval, notify an owner, or stay manual.
- 1Schedule and coverage
Eligibility Verification
A scheduled encounter can trigger a coverage check. Staff review active status, benefit details, and patient responsibility before care or billing decisions move forward.
- 2Payer requirements
Prior Authorization
The worklist brings together the service, diagnosis, payer rule, clinical evidence, submission receipt, and status history for staff review.
- 3Clinical context
AI Medical Scribe and Medical Coding
The provider reviews and attests the note. Coding suggestions and documentation questions then go to a coder or configured approval rule before release.
- 4Pre-bill control
Denial Prevention and Claims
Pre-submission findings can return to the responsible team. The claim moves to the payer only after required checks and release controls are satisfied.
- 5Payer response
Denial Management
Denied and partially denied lines are organized with payer reasons, claim history, remittance details, and supporting evidence for the next reviewer.
- 6Remittance
Payment Posting
ERA and EOB lines are matched and processed under configured rules. Unmatched payments, variances, and reversals stay in human-controlled queues.
- 7Reconciliation
EHR Integration
Approved coverage, authorization, note, code, claim, and payment updates can return to the EHR. Conflicting changes route to a person instead of being overwritten.
Controls your OB/GYN team can verify
Automation should be inspectable before it is trusted. QuickIntell gives operations, clinical, billing, IT, and compliance teams a shared way to define handoffs and review exceptions.
Human review is configurable
Set a workflow step to run automatically, pause for approval, notify an owner, or remain disabled. Confidence, payer, facility, and daily limits can shape those decisions.
Integration follows the available path
Use FHIR or REST where the connected system supports it, browser-based automation for compatible legacy workflows, and a manual fallback while a connection is being validated.
Access and actions stay traceable
Organization-scoped records, role-based permissions, audit logs, and encrypted sensitive credentials support operational review and security due diligence.
Start with evidence, not a broad rollout
Define a baseline, observe the proposed actions, approve real cases, and expand only after your team understands the normal path and the exception path.
- Choose a first payer, facility, and workflow instead of turning on every module at once
- Keep coding, claim release, prior authorization, payment, or EHR write-back behind approval when policy requires it
- Review exceptions and acceptance criteria before adding more volume or another workflow
Map one workflow with us
Bring your current EHR, payer scope, review owners, and one high-friction OB/GYN workflow to a working session.
Plan a workflow reviewSee how your OB/GYN workflow would be scoped
A useful product review starts with a real workflow, not a generic feature tour. Show us where benefit checks, authorization evidence, coding questions, claim release, or patient follow-up breaks down today.
A useful demo includes
- • One representative OB/GYN billing scenario
- • One exception or escalation path
- • The approval, audit, and EHR handoff your team expects
Current EHR
Connection method, source fields, and proposed write-back
Payer scope
Benefit, authorization, claim, and remittance channels
Review rules
Owners, approval gates, confidence thresholds, and escalation
Success baseline
Queue volume, aging, exception types, and acceptance criteria
Implementation starts with one controlled OB/GYN workflow
Scope and sequence are set after discovery. They depend on EHR access, payer channels, data quality, review policy, and the number of modules your team wants to validate first.
Connect the source systems
Confirm how the EHR, clearinghouse, payer portals, and files will exchange the data required by the first workflow.
- Patient, appointment, encounter, and provider fields
- Coverage, claim, status, and remittance sources
- Write-back mappings and conflict rules
Configure controls and owners
Choose the initial module scope, assign each exception queue, and document which actions require a person to approve them.
- Automatic, approval, notify-only, or disabled mode
- Payer, facility, confidence, and daily limits
- Named owners for review and escalation
Validate before expansion
Run representative cases through both the normal path and the exception path, then compare the result with your current process.
- User acceptance with role-based test accounts
- Exception replay and audit-log review
- Training, sign-off, and phased volume increases
A phased implementation path
- 1
Discovery
Select the workflow, systems, payer scope, and baseline
- 2
Configuration
Map data, queues, permissions, approvals, and fallbacks
- 3
Validation
Test normal cases, exceptions, write-back, and audit evidence
- 4
Expansion
Add volume, payers, facilities, or modules after sign-off
Keep people accountable for high-stakes decisions
The goal is not to remove judgment from OB/GYN billing. It is to give each reviewer the right context, a defined queue, and a record of what the system and the team decided.
Approval is a policy choice
Each handoff can run automatically, pause for human approval, create a notification without taking action, or remain disabled. Coding, prior authorization, claim release, payment exceptions, and write-back can retain a person in the loop where your policy requires one.
The EHR remains the clinical source of truth
QuickIntell works alongside the EHR and maps the operational data required by the selected workflow. When both systems change the same clinical field, the conflict is sent to a human reviewer instead of silently overwriting either value.
OB/GYN RCM software evaluation checklist
Compare products on the workflows your team must operate, the exceptions they expose, and the evidence you can inspect. A feature list alone does not show whether the handoffs will work in your environment.
Specialty workflow fit
Maternity episode support
Can the workflow keep benefit dates, patient responsibility, authorization evidence, prenatal services, delivery, and postpartum follow-up connected?
Global package context
Can reviewers see which services belong to an episode and which services need separate documentation, coding, and billing review?
Gynecology procedure workflow
Can payer requirements, clinical evidence, coding decisions, claim status, and denial follow-up stay attached to the same planned service?
Operational control
EHR and payer connectivity
Ask the vendor to show the data source, connection method, write-back fields, conflict handling, and fallback when an API is unavailable.
Human approval and exceptions
Confirm who approves coding, authorization submission, claim release, payment exceptions, and clinical write-back under your policy.
Patient communication history
For QuickVoice use cases, verify how reminders and outbound follow-up are configured, logged, assigned, and handed back to staff.
Ask to see these three things in a demo
One real scenario
Walk from a scheduled encounter through coverage, authorization, coding, claim status, and remittance.
One exception path
Trigger missing documentation, a payer failure, an unmatched ERA line, or an EHR conflict and show who receives it.
The decision record
Show the input, system action, reviewer, approval or rejection, output, and downstream handoff.
Questions for your buying team
- Which system remains the source of truth for patients, appointments, notes, and charges?
- Which payer, facility, and workflow will be validated first?
- Which actions must always require a human signature or approval?
- How will normal cases and exception cases be tested before live volume increases?
- Which queue measures will form the pre-launch baseline?
- Which current security, BAA, access-control, and audit materials are available for review?
Practical RCM review guide
OB-GYN billing readiness across the maternity-code transition
QuickIntell Editorial Team · Guide updated
Keep a longitudinal maternity record while versioning the billing rules by service date. A pregnancy can cross calendar years, payer products, and practice transfers; those changes should remain visible to the coding and contract reviewers.
Review step 1
Preserve the care chronology
Track antepartum visits, labor management, delivery, postpartum work, and transfers with their actual dates and responsible professionals. Do not overwrite earlier services to fit a later billing model.
Review step 2
Prepare a separate 2027 test lane
Have the coding team review the AMA transition guidance and each payer's implementation instructions. Test pregnancies spanning 2026 and 2027 without applying future code rules to current claims or assuming an unchanged global contract.
Review step 3
Keep gynecologic services distinct
For imaging, procedures, and unrelated concerns, preserve the source note, clinical purpose, and responsible billing team. Ask the coder to determine the applicable relationship to maternity services; do not automatically unbundle a service to increase charges.
Measure your own pilot
Track cross-year cases missing a documented billing decision, transfer records awaiting clarification, and payer instructions awaiting confirmation. The goal is a reproducible transition decision, not a forecast of higher reimbursement.
Plan the 2027 code-set release checksSource scope and review limits
AMA maternity-code revisions take effect January 1, 2027. Its transition FAQs distinguish preparation from use of the new reporting framework.
These are editorial workflow recommendations, not clinical advice, claim-specific coding instructions, verified customer results, or an attestation by a credentialed reviewer. Validate current payer rules, licensed code references, and local approvals before use.
CMS coding and coverage reference
OB-GYN billing guidelines: NCCI edits and Medicare coverage
In the CMS NCCI practitioner and ASC procedure-to-procedure table, version v323r0 (2026 Q4), 305 codes in the OB-GYN ranges listed below are column one in 66,349 active pairs, and 68% of those pairs carry modifier indicator 1, so an NCCI-associated modifier can bypass the edit when the record supports a distinct service. The hospital outpatient table holds 52,262 pairs for the same codes. The 2026 Q4 practitioner Medically Unlikely Edit table sets a value for 305 codes in these ranges, all of them applied per date of service, and 269 of the values allow a single unit. 10 codes in the ranges are add-on codes that must be billed with a primary procedure. The most frequent edit rationale is “Misuse of Column Two code with Column One code” (26,835 pairs).
Code ranges counted: 56405-58999 (female genital system); 59000-59899 (maternity care and delivery); 76801-76828 (obstetric ultrasound); G0101 (screening pelvic and breast examination); Q0091 (screening Pap smear collection). The ranges are our selection of where OB-GYN services sit in the code set, not a CMS classification.
What the 2026 NCCI Policy Manual says
A pelvic examination done as part of a gynecologic procedure is not reported separately, and the global obstetric packages (59400, 59510) include antepartum, delivery and postpartum care but not ultrasound, amniocentesis or visits for unrelated conditions. G0101 is reported with a visit only when the two are unrelated, with modifier 25 on the visit.
- Chapter VII: Surgery: Urinary, Male Genital, Female Genital, Maternity Care and Delivery Systems · sections E (Female Genital System), F (Laparoscopy), G (Maternity Care and Delivery) · CPT 50000-59999 CMS PDF
- Chapter XII: Supplemental Services · section C (NCCI Procedure-to-Procedure (PTP) Edit Specific Issues) · HCPCS Level II A0000-V9999 CMS PDF
Most-bundled column-two codes inside these ranges
Each code is the column-two code in this many active practitioner pairs whose column-one code is also in the ranges. Open one in the NCCI checker to see its pairs and modifier indicators.
Local coverage topics
None of the LCD topic comparisons on this site is specific to this specialty. Browse every active LCD by contractor or find the policy for one code with the LCD code lookup.
National coverage determinations
- Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer · NCD 210.2
- Screening for Cervical Cancer with Human Papillomavirus (HPV) · NCD 210.2.1
- Mammograms · NCD 220.4
- Diagnostic Pap Smears · NCD 190.2
- Sterilization · NCD 230.3
Codes, drug classes and payment groups
Sources: CMS Medicare NCCI Policy Manual (2026 edition) and the quarterly NCCI procedure-to-procedure, Medically Unlikely Edit and add-on code files, edit version v323r0 (2026 Q4) effective 2026-10-01; counts computed by QuickIntell from those files, see the methodology. CPT codes are shown as numbers only; CPT is a registered trademark of the American Medical Association. A summary for orientation, not billing or legal advice: check the CMS text and your Medicare Administrative Contractor before you code.
OB/GYN RCM software questions
Answers for practices evaluating workflow coverage, EHR fit, patient communication, review controls, implementation, and security evidence.
Review your workflow with the QuickIntell team
Bring your current systems, one representative scenario, and the exceptions your team needs to control.