Ever upgrade to a new smartphone? A vision of quicker navigation, advanced features, and modern design could make anyone excited. But if the setup process goes wrong, you risk being left without access to your contacts, apps, or photos.
The potential issues are analogous in healthcare—missing information, gaps in billing, access issues—but the stakes are so much higher. Investing in a new OBGYN EHR system is a significant step. A modern system can enhance patient care, improve documentation, and streamline workflows. However, without careful planning, your revenue process can decline, leading to claim denials, cash flow issues, and compliance risks.
Billing errors are among the most common pitfalls during an OBGYN EHR system transition. From clearinghouse disruptions to lost financial data, these issues can severely impact your revenue cycle. Here are five OBGYN billing mistakes to avoid when switching to a new system.
One of the biggest risks during an OBGYN EHR system transition is failing to migrate billing data accurately. Lost or corrupted financial records can lead to claim denials, payment delays, and incorrect patient balances. Research on data migration projects found that nearly 38% run over budget or experience significant delays due to errors, making careful planning essential.
Additionally, practices often underestimate how much historical billing data needs to be transferred. This includes patient demographics, outstanding claims, insurance contracts, and financial reports. If this information is incomplete or inaccurate, your practice may struggle with reimbursement issues long after the transition.
Work closely with an experienced OBGYN EHR system vendor to develop a structured data migration plan. Before going live, validate all transferred billing data, test claim submissions, and cross-check financial records to ensure accuracy. Running a limited number of claims in the new system before full implementation can help identify any errors early.
Switching to a new OBGYN EHR system often means transitioning to a different clearinghouse. This change affects how your claims are submitted and processed. If payer enrollments are not updated, or if there's a misalignment between your clearinghouse and your EHR, you could face delays in claims processing, rejected submissions, and a disrupted revenue cycle.
Clearinghouse changes can also affect Electronic Remittance Advice (ERA) and payment postings. If not managed correctly, these issues can lead to lost payments or increased administrative work for your billing staff. For example, the American Medical Association reports that disrupted health information exchanges during EHR changeovers can create obstacles to communication and data flow.
Notify payers about your system change in advance and update all clearinghouse enrollment details to prevent claim submission delays. Work with your new EHR vendor to ensure a seamless integration between the clearinghouse and your OBGYN billing workflows. Monitor initial claim submissions closely to prevent disruptions and have contingency billing workflows in place in case of processing delays.
Even with the most advanced OBGYN EHR system, poorly trained staff can make critical billing errors. A lack of familiarity with the new system can lead to coding mistakes, missed modifiers, and incomplete claims, all of which can cause denials and delayed reimbursements.
Sure, billing errors impact revenue. But they can also lead to compliance issues. Incorrectly submitted claims may result in audits or penalties, especially for services covered under Medicaid or private insurance plans with strict documentation rules. EHR transitions are infamous for being highly disruptive and affecting clinician and staff experiences, highlighting just how essential training is.
Conduct extensive training sessions for all billing and administrative staff before launching the new OBGYN EHR system. Focus on hands-on practice, provide detailed guides, and establish a support system for questions. Encourage ongoing education, especially for areas like OBGYN billing compliance and claim resubmissions. Designate super-users who can assist colleagues with troubleshooting as they adapt to the new system.
During an OBGYN EHR system switch, billing teams often focus on setup and forget about monitoring claims. This lack of oversight can cause claim submission backlogs, overlooked denials, and an increase in rejected claims that go uncorrected.
Practices may also experience unexpected shifts in reimbursement patterns due to system configuration differences. If left unaddressed, these issues can severely impact cash flow and require extensive rework to resolve.
Assign dedicated billing staff to track claims in both the old and new systems for at least the first few months after the transition. Run dual reports comparing claims data before and after migration. Use analytics tools to flag discrepancies early and ensure claims are being processed efficiently.
Additionally, create a workflow for reviewing and addressing denials quickly. Set up alerts in your new OBGYN EHR system to notify staff of rejected claims so they can be corrected and resubmitted promptly.
Shutting down your old EHR system too soon can create billing gaps, leading to lost claims and compliance challenges. Without access to historical billing data, troubleshooting errors becomes difficult, and your practice may struggle to submit accurate claims.
A dual-system period allows your team to compare records, ensure billing continuity, and identify any missing data before fully committing to the new platform. Without this overlap, small errors can snowball into major financial setbacks.
Plan for a dual-system period of at least 60–90 days after switching to your new OBGYN EHR system. This transition time ensures staff can cross-check billing records, follow up on pending claims, and adjust to new workflows without losing revenue. If your old system allows for limited access, retain historical billing records for an extended period to support audit requests and claims reconciliation.
“WRS makes lots of advancements…If it’s something that makes sense and it’s efficient they’ll definitely make a change to their EMR system. They love to serve their clients.”
Switching to a new OBGYN EHR system doesn’t have to disrupt your revenue cycle. By avoiding these five common billing mistakes, your practice can maintain financial stability and ensure a smooth transition. Careful planning, staff training, and ongoing monitoring will help you maximize the benefits of your new system while minimizing billing-related risks.