Do you know that obstetrics billing is often perceived as straightforward because of the global maternity package ? And this assumption has frequently led to revenue leakage. This is because obstetrics billing is not as easy as it may seem.  Especially when care does not follow the “textbook” maternity timeline, complications seem like a growing maze for many OBGYN physicians.  

In real-world clinical settings, pregnancies are rarely linear because patients relocate, switch providers, or change insurance coverage mid-pregnancy. These disruptions expose two uncommon but high-impact obstetrics billing services issues that many practices struggle with: a global OB billing breakdown due to partial care and incorrect handling of transfer of care. 

While it is also true that these scenarios do not occur daily however, when they do arise, they create confusion, compliance risk, and lost revenue. Thus, understanding these issues is extremely vital here. While it is quite a demanding and challenging area, OB physicians today are more inclined to outsource their billing to better provide proper patient care and protect reimbursement and payer relationships. 

All about the Global OB Billing Breaks Due to Partial Care and Incorrect Handling of Transfer of Care 

1. Global OB Billing Breaks Due to Partial Care - It is during pregnancy that the global obstetric billing assumes continuity of care across three phases:  

• antepartum 
• delivery 
• postpartum 

While the global maternity package works well only when a single provider or group delivers all three components, we must also know that dual and multiple providers here only create more confusion. 

 In short,  partial care scenarios disrupt this model. Specifically, when the registered patients switch providers. It can be due to mid-pregnancy due to relocation, referral to a high-risk specialist, dissatisfaction or even changes in insurance networks; the billing must be adjusted accordingly. In other cases, insurance coverage is terminated before delivery, requiring billing under a new payer for different portions of care; when this happens, the global OB package must be unbundled correctly. Here, each phase must be billed independently using appropriate CPT codes. This is when a professional billing expert can be of great help. 

 As this is where many practices encounter problems. The billing team during antepartum care needs to be extra careful so it does not go underbill. Delivery services may not be incorrectly bundled, or postpartum visits may not be missed; entirely professional billers are needed. In some cases, practices mistakenly bill a full global package despite providing only partial services, exposing themselves to payer audits and recoupments. Thus, billing for obstetrics services one need a professional. 

 The right team can understand where the real challenge lies, starting with accurately determining how many antepartum visits were rendered, whether the delivery qualifies for separate billing, and whether postpartum care was completed by the same provider. These determinations require precise documentation and payer specific knowledge, which comes with experience. As here, even experienced in-house billing teams may struggle when such cases occur infrequently. 

2. Incorrect Handling of Transfer of Care - Closely tied to partial care is the issue of transfer of care. A transfer of care typically occurs when responsibility for a patient’s obstetric management is transferred from one provider to another. This could happen during pregnancy, at delivery, or even postpartum, which means anytime. 

From a billing perspective, transfer of care is not merely a clinical event; it is a billing determinant that requires additional documentation work. Every payer requires clear evidence of the care provided to the patient. And even when the responsibility officially changed. Without all this documentation, OB claims are vulnerable to denial, downcoding and sometimes post-payment audits. 

In fact, one of the most common mistakes is the failure to include a formal transfer-of-care note. Without it, payers may assume overlapping services or duplicate billing. This can lead to underpayment for one provider and overpayment for another, followed by payer recoupments months later. Additionally, practices often fail to adjust billing codes correctly after a transfer.  Antepartum care may need to be billed using visit-based codes rather than global codes. Thus, delivery services must be billed with the correct modifiers and postpartum care must be carefully timed and documented to avoid duplication. 

Because transfer-of-care scenarios are relatively uncommon, many internal teams lack standardized workflows to manage them efficiently. The result is inconsistent billing, delayed payments, and unnecessary payer disputes. 

How can you solve these Obstetrics Billing issues that are overlooked 

Both partial care and transfer-of-care issues fall outside routine obstetrics billing workflows as they do not follow predictable patterns. Thus, many practices here also rely on automated systems or standard billing templates that are not designed to handle these exceptions. In fact, in today's competitive era, outsourcing obstetric billing to an experienced team is quite profitable. 

Moreover, payer rules for global OB billing vary widely. What qualifies as billable partial care under one payer may be bundled under another. While keeping track of these variations demands ongoing education and payer policy monitoring, which can be a pain point for in-house experts, professional here can do wonders without compromising on standards or productivity.  

How Outsourcing Obstetrics Billing Solves These Challenges 

For many obstetrics billing partners, managing all these uncommon but complex scenarios, like partial care and transfer of care, is easy. This is because these specialized billing partners bring focused expertise, established workflows, and payer-specific knowledge that significantly reduce risk. 

Experienced outsourcing partners here not only understand how to break global OB packages accurately, but also when to apply antepartum only codes, delivery-only codes, or postpartum visit billing. This ensures that each care portion is reimbursed correctly without triggering compliance issues. 

Outsourced billing teams in fact, actively audit clinical documentation to confirm that transfer of care notes are present and properly dated. If documentation is incomplete, they flag it early, long before claims are submitted. Thus preventing denials and recoupments. So with the right billing partner, you not only enjoy seamless billing transactions but also an efficient cash flow. Struggling to manage complex obstetrics billing? Get in touch with experts.