Practice profile
- Providers
- 2–10 OB-GYNs + NPs/midwives
- Specialty
- Obstetrics + gynecology; sometimes maternal-fetal medicine
- Payer mix
- Commercial + Medicaid; heavy prenatal and delivery reimbursement
- Monthly encounters
- 1,500–6,000
- Typical revenue
- $2M–$12M net collections/year
- Staff model
- Practice administrator, sonographer(s), MAs, front desk, in-house or specialty billing
The four decisions that matter most
Decision
EHR selection
Recommendation: OB-GYN-configured EHR with prenatal flow sheets, ultrasound integration, and global OB workflow
Why: Prenatal documentation, ultrasound reporting, and hospital handoffs are OB-GYN-specific workflows generic EHRs handle poorly.
Decision
Billing partner
Recommendation: Specialty billing partner or in-house biller with OB-GYN coding certification
Why: Global OB billing (CPT 59400 and family) has specific antepartum-visit-count rules and split-billing scenarios that generalist billers routinely mis-bill.
Decision
Credentialing
Recommendation: Coordinator handling both payer enrollments and hospital delivery privileges
Why: OB-GYNs need hospital privileges for deliveries; managing that in parallel with payer enrollment is different from office-only credentialing.
Decision
AI scribe
Recommendation: Pilot for gynecology visits and prenatal check-ins; be cautious with sensitive-topic encounters
Why: Ambient scribes work well for structured prenatal visits and annual gyn exams; sensitive-topic conversations require explicit patient consent scripts.
Recommended vendor stack
Each recommendation links to the relevant buyer guide for deeper criteria.
| Category | Recommendation | Why it fits | Budget |
|---|---|---|---|
| EHR | OB-GYN-configured EHR with prenatal flow sheets, ultrasound reporting, and global OB workflow | Specialty-fit is worth more than brand recognition in OB-GYN. Generic EHRs typically bolt on prenatal templates as an afterthought. | $500–$1,100 / provider / month |
| Billing & RCM | OB-GYN-specialty billing or in-house biller with certified OB-GYN coder; annual external audit | The dollar impact of correct global OB billing dwarfs the cost of specialist billing help. | 4–7% of net collections |
| Credentialing | Coordinator (internal or outsourced) with hospital privileging expertise | Hospital delivery privileges take a separate workflow that generalist credentialing services often mishandle. | $250–$450 / provider / month or internal FTE |
| AI Scribes | Ambient scribe piloted in gyn and prenatal workflows with explicit consent scripts | Real time savings; deploy with patient-consent language reviewed by counsel. | $200–$350 / provider / month |
| Consulting | OB-GYN-specific ops consultant for payer contracting and call-coverage models | Payer contracts around global OB rates and call-coverage economics are specialty-specific. | $4K–$10K / month or per project |
Approx. total: 10–16% of net collections in vendor spend at maturity.
First-year buying playbook
Q1
Global OB audit. External audit of last 12 months of global OB billing; recoup opportunities identified.
Q2
Ultrasound + lab economics. Ultrasound and lab margin reports live; in-office vs referral decisions documented.
Q3
Payer negotiations. Top 2 commercial contracts renegotiated with global OB rate benchmarks.
Q4
AI scribe rollout. Ambient scribe live in gyn + prenatal with documented consent workflow.
Vendor red flags for this archetype
- Billing vendors that can't articulate how they handle antepartum visit counts and split global OB billing.
- EHR vendors without native ultrasound / imaging integration.
- Credentialing vendors that treat hospital privileging as an add-on service.
- AI scribe vendors without documented consent scripts for sensitive-topic encounters.
Common mistakes
- Under-investing in OB-GYN-specific coding expertise.
- Choosing an EHR without native imaging integration.
- Delaying hospital-privileging renewals or letting them lapse.
- Rolling out AI scribes without patient-consent language reviewed by counsel.
When to revisit this stack
- Global OB rate changes at top payers.
- State Medicaid MCO changes affecting maternity coverage.
- In-office lab / ultrasound expansion decisions.