Care lost mid-pregnancy
When a patient transfers in or out partway through pregnancy, a global package no longer applies, and from 2027 every prenatal visit is reported on its own. Either way, unless each visit reaches a claim, the care goes unpaid.
We help medical practices of every kind collect more, lower billing costs and strengthen payer contracts. Obstetrics, maternal-fetal medicine (MFM) and women's health are where we go deepest: our founders grew an MFM practice into a regional specialty network, and pregnancy care is billed, staffed and contracted unlike almost anything else in medicine.
Results reported by the practice. Figures are approximate. Results vary and are not guaranteed.
Read: MFM Practice Case Study: From Referrals to Owning Care →
Pregnancy care is billed differently from almost everything else in medicine. These are the patterns we look for first, because each one is common, quiet, and fixable.
When a patient transfers in or out partway through pregnancy, a global package no longer applies, and from 2027 every prenatal visit is reported on its own. Either way, unless each visit reaches a claim, the care goes unpaid.
Visits for complications can often be billed separately from routine care, when the note supports it. When they're folded into routine care, the extra work is done for free.
Detailed anatomy scans are denied when the note doesn't support medical necessity. The scan was done; the documentation didn't follow.
Non-stress tests and biophysical profiles are easy to miss in a busy clinic, or to bundle incorrectly. Each one is small. Across a year, they add up.
Genetic testing and advanced imaging often need approval first. When an authorization slips, the claim becomes a write-off.
When a specialist and an obstetrician care for the same patient, overlapping claims can cancel each other out, and one side goes unpaid.
Source: American Medical Association (AMA), CPT 2027 maternity care services FAQ. Billing rules vary by payer.
The single bill that covers a whole pregnancy goes away, and prenatal visits, labor, delivery and postpartum care are billed on their own. One bill becomes a dozen or more, and any visit that never reaches a claim doesn't get paid.
Work that used to ride inside the package now has to be documented, coded and billed visit by visit, including visits for patients who transfer in or out.
Payer contracts priced around the global package may not fit billing by phase. Reviewing them before 2027 can protect revenue the practice already earns.
Scheduling, eligibility checks and charge entry all carry more weight when each visit stands alone. A 90-day plan gives the team time to adjust.
Read: Global OB Billing Ends in 2027: What Practices Should Do →
Our 90-day plan (Assessment, Action, Results) works for any specialty. In obstetrics and MFM, it reaches a little further.
We trace where pregnancy care falls out of billing, from transfers of care to fetal testing, and fix it with your team or billing vendor.
When a specialist and an obstetrician share a patient, clear handoffs protect both the care and the claims on each side.
Standard, physician-written protocols can make high-risk care more predictable and easier to measure against statewide outcomes data.
Good outcomes often stay invisible to payers. Benchmarked results give a practice a stronger case at the negotiating table.
Some MFM practices grow by delivering care directly, adding obstetricians and midwives alongside their specialists.
For multi-site OB-GYN groups and PE-backed women's health platforms, we compare locations and lift each one toward the best.
No. We work with medical practices, specialty practices, physician groups, health systems and PE-backed platforms across specialties. Obstetrics, MFM and women's health are where we go deepest, because that's where our founders built and ran a practice.
For dates of service starting January 1, 2027, the global obstetric package is replaced by separate billing for prenatal visits, labor, delivery and postpartum care. Each visit has to reach a claim on its own, per the AMA's CPT 2027 maternity care FAQ. Our 2027 brief includes a 90-day checklist.
It can. In one case, a maternal-fetal medicine practice added its own obstetricians and midwives, standardized physician-written protocols, benchmarked outcomes and renegotiated payer contracts. It reports growth of 30–40% a year since 2023. Read the MFM case study.
In our experience, it often slips in transfers of care, high-risk visits billed as routine, ultrasounds denied for documentation, fetal testing that's never charged, missed prior authorizations, and OB and MFM claims that collide. Each is common and usually fixable.
Yes. For multi-site groups and PE-backed platforms, we benchmark collections, billing cost and contracts by location, and use outcomes across the platform to support stronger payer rates.
With a free discovery call, where we take a first look at your numbers from summary reports you share. If we're a fit, we start a 90-day plan, beginning with the Assessment.
Start with a free first look at your numbers in a discovery call.