Split billing for OB

Why This Topic Matters

Split billing in obstetrics can affect how maternity services are reported and paid when responsibility for care changes mid-pregnancy. Understanding the general scenarios covered here helps practices identify when global billing may not apply and when separate billing pathways may be relevant.

Article Sections

1. Scenario No. 1

   Discusses a situation involving physician coverage within a group practice and different ways the maternity services may be billed when one physician is unavailable. The section compares several broad billing approaches and notes that payer requirements may differ.

2. Scenario No. 2

   Covers a transfer of obstetric care between practices during pregnancy and how the receiving practice may account for services already provided elsewhere. The section also addresses a reduced-services approach and the importance of payer guidance.

3. Scenario No. 3

   Describes a change in insurance during pregnancy and the resulting split between the initial payer and the new payer. The section outlines how remaining maternity services may be divided across the insurers and notes that carrier agreements can affect responsibility.