Specialized Emergency Room Billing Solutions for Maine Healthcare Providers
We provide expert emergency room billing services to ensure accurate coding, prompt submission and regular follow up. Our emergency room billing services are bespoken to your needs in Maine.
Why Choose Our Emergency Room Billing Services in Maine?
Transparent Emergency Billing Reports
Our reports will give you an overview of claim submissions, collections, denials and outstanding amounts. This helps make the administration of emergency room billing easier.
Emergency Department Billing Expertise
Our emergency room billing services offer tailored solutions for emergency medicine. We offer E/M coding, critical care, diagnostic and facility and professional billing.
Accurate Claims and Coding
Our team will review documentation from the encounter, verify charges and apply correct codes including CPT, HCPCS & ICD-10-CM codes.
HIPAA-Conscious Billing Support
We apply correct practices for patient data handling, and use billing procedures that are in accordance with the privacy and security necessities of the HIPAA.
Claim Submission
We will produce emergency room claims and submit them to Medicare, Maine Care & Commercial Insurance providers. We will ensure all claims are correctly coded and that they contain the right information.
AR Follow-Up
Our AR team will ensure we follow up on any outstanding emergency room claims. We will chase up the insurance companies and investigate why we haven’t received payment.
Insurance Verification
Our team will check what insurance the patient has, what their eligibility is and what cover they have. We will check if there are any authorizations required.
Charge Entry & Coding
Our team will check the documentation from the emergency encounter and apply the correct CPT, HCPCS & ICD-10-CM codes. We will ensure E/M levels, critical care and documented procedures are correctly coded.
Payment Posting
We will post payments from the insurance companies, adjustments & patient liability. We will also reconcile ERA/EOB information. We will check claims to ensure there are no discrepancies, underpayments and outstanding balances.
Facility & Professional Billing Reconciliation
Our team will check facility and professional billing to ensure we have correctly billed for the services provided in the emergency room. We will check charges, documentation & claims to look for discrepancies.
Emergency Department Denial Management
Our team will check denied emergency claims to find out why they were denied. We will identify any coding, medical necessity, eligibility, documentation & insurance issues. We will help resolve claims to ensure they’re corrected and resubmitted. We can also support appeals.
Reporting & Analytics
Our reporting will provide an overview of claim status, reimbursement, denial trends & AR. This helps emergency room administrators to identify any issues with the billing.
Our End-to-End Emergency Room Billing Process
Client Onboarding & EHR Integration:
- Understand your emergency department’s billing workflow and coordinate compatible system access.
Charge Capture & Coding Review:
- Validate documented services, procedures, E/M levels, and applicable diagnosis codes.
Payment Posting & Remittance:
- Record payments, adjustments, and patient responsibilities using remittance information.
Monthly Reporting:
- Provide billing performance updates covering collections, denials, and accounts receivable.
Patient Information & Eligibility Checks:
- Review registration details, insurance information, and available coverage records.
Claims Submission & Scrubbing:
- Review claims for common errors before submitting them to the appropriate insurance companies.
AR & Denial Follow-Up:
- Investigate unpaid claims, address correctable denials, and follow up on outstanding balances.
Feedback & Workflow Reviews:
- Discuss recurring billing issues and opportunities to improve your revenue cycle process.
Common CPT Codes Used in Emergency Room Billing
There are a variety of codes used for emergency room billing including E/M, critical care, diagnostics & procedures. Our team will check the documentation to ensure the correct codes are used.
| CPT Code | Service Description |
|---|---|
| 99281–99285 | Emergency department evaluation and management services |
| 99291 | Critical care, first 30–74 minutes |
| 99292 | Additional qualifying critical care time |
| 93010 | ECG interpretation and report |
| 71045 | Chest X-ray, single view |
| 80053 | Comprehensive metabolic panel |
| 96374 | Therapeutic, prophylactic, or diagnostic injection by intravenous push |
The above are examples of common codes used in the emergency department. The codes will depend on the services provided, documentation, current CPT guidelines & insurance requirements. There may be different requirements for professional and facility billing.
Core Specialties We Serve — Tailored for Maine Providers
We offer medical billing & revenue cycle support to healthcare organizations throughout Maine including hospitals, emergency rooms, outpatient facilities & private practices.
- Emergency Medicine
- Urgent Care
- Family Medicine
- Internal Medicine
- Behavioral & Mental Health
- Emergency Room
- Cardiology
- Neurology
- Orthopedics
- Oncology
- Pediatrics
- Obstetrics & Gynecology
- General Surgery
- Pain Management
Frequently Asked Questions (FAQs)
What types of emergency department claims do you handle?
We offer support with emergency room billing for professional and facility claims. We offer support with E/M, critical care, diagnostics & documented procedures. Billing will depend on your facility requirements.
Do you offer support with Maine Care & Medicare emergency room billing?
Yes, we do. We offer support with processing emergency room claims for Medicare, Maine Care & commercial insurance. We will ensure we are aware of the requirements for each insurance provider to ensure accurate claims are submitted.
What is the difference between emergency room facility & professional billing?
Facility billing includes hospital resources, supplies, equipment & other services within the department. Professional billing includes physician services, evaluations & procedures. Both require correct documentation.
What CPT codes are commonly used for emergency room visits?
A few examples of common CPT codes are 99281-99285. There are other codes that might be used for critical care (99291 & 99292), for ECG (93010), for IV push (96374), etc.
Can you help reduce emergency room claim denials?
Yes, we can. We will investigate denied claims and identify any coding, documentation, eligibility & insurance issues. We will help resolve claims to ensure they’re correctly coded and appealed.
Can you integrate with our EHR & billing software?
We can discuss integrating with your EHR & practice management systems. Our team will check how you currently bill and ensure we have processes in place that are compatible.
How do you manage emergency room AR?
We will track any outstanding claims. We will check responses from payers, investigate any delayed payments and follow up on any outstanding balances. We will regularly check claims to identify any that are outstanding.
Are your emergency room billing services HIPAA compliant?
We follow HIPAA standards to ensure privacy & security. We will ensure we follow correct measures when handling protected health information.
Strengthen Your Emergency Department Revenue Cycle Today
Managing emergency claims, coding requirements, and insurance follow-ups can place pressure on your administrative team. Let us help streamline your billing operations and support more consistent reimbursement.