AI claim scrubber for OB/GYN billing
Syntra reviews office procedures and ultrasound documentation so endometrial sampling, colposcopy, and imaging are billed distinctly from the E/M when supported. Syntra is an AI claim and chart scrubber that reviews OB/GYN documentation against the claim before submission, so billing teams prevent denials instead of working them.
Example capture
58100 · Endometrial biopsy
Note documents endometrial sampling as a distinct procedure, not included in the office visit. Supports separately reporting 58100 when modifier -25 criteria are met.
What causes OB/GYN claim denials?
Most OB/GYN denials trace back to the chart: a service documented but not coded, a code the note does not support, or a modifier that is missing. These are the patterns Syntra checks on every OB/GYN encounter before submission:
- Office procedures bundled into the E/M when modifier -25 criteria were met but not documented
- Global obstetric package services billed separately
- Ultrasound billed without the complete-exam elements the code requires
Which OB/GYN modifiers and edits does Syntra check?
Syntra applies NCCI (CCI) edits, MUEs, and payer rules, then confirms each modifier is supported by the documentation rather than added to get past an edit. Common OB/GYN modifiers it validates:
- -25 on E/M with same-day procedures
- -59 for distinct procedures
- -TH for obstetric services outside the global package
Obstetric global billing and preventive-versus-problem visit splits vary by payer and plan type.
Those checks follow public payer rules, including CMS National Correct Coding Initiative (NCCI) edits and Medicare Coverage Database (LCDs and articles). Syntra applies the rule to the note, which a claim-only edit cannot see.
How is this different from OB/GYN billing software or a clearinghouse scrubber?
Billing software, practice-management systems, and clearinghouses scrub the claim after it is built: required fields, code pairs, and payer edits. They usually cannot see the clinical note. Syntra reasons on the note and the claim together, the way an experienced OB/GYN coder would, which is how it finds undercoding and compliance risk that claim-level rules pass through. It sits on top of your existing revenue cycle management (RCM) stack rather than replacing it.
Read more on how Syntra differs from EHR scrub rules and clearinghouse claim scrubbers.
OB/GYN claim scrubber FAQs
- What is the best claim scrubber for OB/GYN practices?
- The best OB/GYN claim scrubber reads the chart, not only the claim. Syntra is an AI claim and chart scrubber that compares OB/GYN documentation to the codes, modifiers, and payer rules before submission, so missed revenue and denial risk are caught while the encounter can still be corrected.
- How does Syntra reduce OB/GYN claim denials?
- Syntra checks every encounter for the denial drivers common in OB/GYN, including NCCI bundling, missing or incorrect modifiers, medical necessity, and global-period conflicts. It flags issues before the claim leaves the practice, which raises the clean claim rate instead of working denials after the fact.
- Does Syntra replace my OB/GYN billing software or EHR?
- No. Syntra sits on top of your existing EHR, practice-management system, and clearinghouse. It adds chart-level pre-bill review to the revenue cycle (RCM) stack you already run.
- Which EHRs does Syntra support for OB/GYN?
- Syntra integrates with Epic, Cerner, NextGen, Nextech, SIS, iMedicWare, athenahealth, eClinicalWorks, Optivate, and ModMed. If your OB/GYN practice uses another EHR, a dedicated engineer builds a custom integration.
- How do OB/GYN practices get started?
- Every practice starts with a complimentary retroactive audit of recent OB/GYN charts and claims. Syntra then moves to controlled pre-bill review and, over about 90 days, autonomous submission on eligible encounters with humans in the loop.
See other specialties, EHR integrations, or how pre-bill review works.
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