Emergency-Room Billing That Gets Paid—Fast

U.S.-based ER billing for hospital emergency departments—97% clean claim rate, 60% fewer denials, and 24/7 coding support for trauma, critical care, and high-volume EDs.

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Why Hospitals Trust Our Emergency-Room Billing

Accurate E/M & Trauma Coding

Expert use of 99281–99285, critical care (99291), and trauma activation codes—validated against clinical documentation to prevent under/over-coding.

24/7 Coding & Support

Round-the-clock coverage ensures claims are coded and scrubbed within hours of patient discharge—no weekend or holiday delays.

60% Fewer Claim Denials

Pre-submission edits catch missing modifiers, eligibility lapses, and payer-specific ED rules before claims go out.

Seamless EHR Integration

Works with Epic, Cerner, Meditech, and eClinicalWorks—no duplicate data entry or workflow disruption in fast-paced ED environments.

Rapid Denial Appeals

Denied claims are appealed within 48 hours with clinical documentation support—recovering 87% of lost ER revenue.

Dedicated ED Billing Manager

Your U.S.-based expert monitors ED-specific KPIs: charge lag, coding accuracy, denial root causes, and payer performance.

Emergency Department Billing Challenges

ER billing is high-pressure, high-volume, and high-risk for denials due to documentation gaps, coding complexity, and payer scrutiny.

Incomplete Provider Documentation

Rushed notes often lack key elements (HPI, ROS, MDM), leading to E/M downgrades or denials for medical necessity.

High Denial Rates (20–35%)

Payers aggressively audit ED claims for observation vs. ER status, duplicate billing, or missing trauma activation details.

Delayed Charge Capture

Manual or fragmented workflows cause 3–5 day charge lag—increasing risk of missed revenue and compliance exposure.

Payer-Specific ED Policies

Commercial payers (e.g., United, Aetna) have strict rules for ED visits—non-compliance triggers automatic denials.

Our ER Billing Workflow

Designed for hospital emergency departments that need speed, accuracy, and compliance.

1. Real-Time Charge Capture

Track procedures, medications, and E/M levels during patient visit via EHR or mobile intake.

2. Clinical Documentation Review

Validate provider notes for E/M level support, trauma criteria, and critical care time documentation.

3. Accurate Coding & Modifiers

Assign correct CPT/HCPCS, E/M level, and modifiers (-25, -59) based on payer-specific ED guidelines.

4. Clean Claim Submission (Within 24h)

Submit scrubbed claims daily; monitor for real-time payer edits and auto-correct.

5. Denial Prevention & Revenue Reporting

Monthly dashboard: denial trends, top DRGs, payer performance, and actionable optimization insights.

Proven Impact for Hospital EDs

0%

Clean Claim Rate

0%

Fewer Denials

0%

Higher Net Collections

Based on 42 emergency departments served in 2024. Results may vary.

Want to Master ER Billing Compliance?

Read our in-depth guide on reducing denials and optimizing revenue in high-volume emergency departments.

Read Our ER Billing Guide

Emergency-Room Billing: FAQs

Yes—we specialize in complex ED coding, including trauma team activation (G0390), critical care time (99291/99292), and E/M with procedure bundling rules.

We work with your clinicians to implement structured templates and provide retrospective documentation support to ensure defensible coding.

Absolutely. We follow CMS and commercial payer guidelines to assign the correct status, avoiding costly denials for incorrect place of service.

Yes—our U.S.-based team provides 24/7 coverage for charge capture, coding, and claim submission, ensuring no revenue delay.

Stop Losing ED Revenue to Billing Gaps

The average emergency department loses $120K–$300K/year to under-coded E/M levels, missed trauma charges, and slow denial follow-up.

97%
Clean Claim Rate
60%
Fewer Denials

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