OB/GYN Medical Billing Services in Pennsylvania
AMS Solutions provides specialized ob/gyn medical billing for Pennsylvania practices — Philadelphia, Pittsburgh, Allentown, Harrisburg, and statewide. Our AAPC-certified billers handle the maternity global package (59400, 59510, 59610, 59618), the full ultrasound code set (76801-76817), and GYN procedures and the Pennsylvania payer mix that other billing companies miss.
Pennsylvania-specific payer landscape
Pennsylvania OB/GYN billing crosses PA Medicaid HealthChoices (Aetna Better Health, Geisinger, Health Partners, Keystone First, UPMC for You), Independence Blue Cross, Highmark BCBS, UnitedHealthcare, Aetna, Cigna, and Medicare. Novitas is the MAC for PA Medicare Part B.
Where Pennsylvania ob/gyn revenue leaks
- PA Medicaid HealthChoices PA-MCO patient transfers mid-pregnancy
- Multi-gestation ultrasound coding (76802, 76810)
- Same-day GYN procedure + E/M bundling without Modifier 25
- PA-specific newborn coverage timing rules
- Highmark vs Independence BCBS jurisdictional confusion
What AMS handles for Pennsylvania practices
- Pre-encounter eligibility verification and benefit checks
- Coding, charge entry, and claim submission
- Denial management and appeals (we don’t write off — we fight)
- A/R follow-up and patient statements
- Monthly reporting tied to your practice management system
Pennsylvania compliance
Pennsylvania Department of Health 7-year record retention + HIPAA + PA Breach of Personal Information Notification Act compliance. AAPC-certified, $5M E&O.
Get a OB/GYN Billing Assessment for Your Pennsylvania Practice
Call (214) 571-6317 or book a 30-minute review with our team.
Yes — Aetna Better Health, Geisinger, Health Partners, Keystone First, UPMC for You, and all major PA MCOs.
We bill based on the patient’s plan jurisdiction (Highmark covers western PA, Independence covers eastern PA) with the correct payer ID and submission protocols.
Yes. We split the global maternity package into antepartum (59425/59426), delivery (59409/59514), and postpartum (59430) — billed to the correct payer for each segment.
95%+ on first pass.
Yes. We meet both standards with documented BAAs.
Related resources
See our full OB/GYN Medical Billing services, or download the 2026 OB/GYN CPT Cheat Sheet.