OB/GYN Revenue Cycle Overview
OB/GYN revenue cycle management is complicated by the global obstetric billing model, which delays revenue recognition for months of antepartum care until delivery. This creates a unique cash flow pattern where OB revenue arrives in large, periodic payments rather than the steady daily stream seen in most specialties. Gynecologic services provide the steady baseline revenue, while OB deliveries create revenue peaks. Managing both streams requires distinct metrics and different cash flow planning.
Revenue Per Delivery
Average revenue per delivery (global package) should be $2,000 to $3,500 depending on payer mix and delivery type. Practices averaging below $1,800 per delivery may have payer contract rate issues or may be failing to bill separately for complications and non-routine services. Track revenue per delivery by payer and by delivery type (vaginal vs. cesarean) to identify specific contract deficiencies.
Revenue Per Gynecologic Visit
Average GYN visit revenue should be $130 to $190, similar to primary care but boosted by same-day procedures (colposcopy, endometrial biopsy, IUD insertion). Practices below $120 per GYN visit are likely missing procedure charges, undercoding E/M levels, or failing to bill both preventive and problem-focused services on split visits.
Days in Accounts Receivable
AR days for OB/GYN must be interpreted carefully. GYN claims should adjudicate in 24 to 30 days (standard). Global OB claims may show 35 to 45 days from submission to payment, but the true revenue delay is much longer when counting from the first antepartum visit. Tracking AR separately for OB and GYN claims provides a more accurate picture than a blended number.
Delivery Volume and Forecasting
Track monthly delivery volume and expected deliveries by due date. This allows cash flow forecasting: if 15 deliveries are expected next month at $2,500 average, $37,500 in global OB revenue should arrive within 30 to 45 days of those deliveries. A sudden drop in delivery volume affects revenue 30 to 60 days later, giving the practice time to adjust if the trend is identified early.
Net Collection Rate
Net collection rate for OB/GYN should be 95% or higher. The primary collection challenges are high patient responsibility on global OB fees (deductibles and coinsurance on a $2,500+ charge can be $1,000+) and missed collections on split preventive/problem visits where the patient copay structure differs between preventive (often $0) and problem-focused ($30-50 copay) services.
Procedure Revenue as Percentage of GYN Revenue
In-office procedure revenue should represent 15% to 25% of total GYN revenue. Practices below 10% are either referring procedures to the hospital (losing the facility and professional revenue) or are not performing the range of in-office procedures their patient population supports. Expanding in-office procedure capability is one of the highest-return investments for GYN revenue growth.