We know why your 99291 got denied. And how to prevent it.
Emergency Medicine Medical Billing and Coding Services
Emergency department billing is unlike any other specialty. Thousands of visits per month. constant regulatory shifts. and high audit risk. Denials strike hardest on codes like 99291. 99292. and 99285.
Preferred MB transforms fast-paced ED charts into clean claims. We capture every reimbursable minute. validate provider attribution. and block payer edits before they strike.
- 14 to 20 percent reduction in ED denials
- 99291 and 99292 approved above 94 percent first pass
- 20 day average AR cycle
Turning Chaotic ED Notes Into Clean Claims
The emergency department generates fragmented data at high speed. Triage notes. physician dictation. procedures. and test results must all flow into one clean bill. Preferred MB builds the bridge.
Capture Clinical Story
- Link presenting complaint and differential diagnosis to E/M level
- Ensure risk factors and comorbidities are documented for medical necessity
Code With Precision
- Validate 99291 and 99292 against time and activity requirements
- Confirm procedures like intubation or laceration repair are captured with correct modifiers
Sync With EHR
- Reconcile orders and results across Epic. Cerner. Meditech
- Confirm supervising provider attribution before submission
Track Claims in Motion
- Validate place-of-service for hospital ED vs freestanding ED
- Match encounter data to payer edits before transmission
Close Denials Fast
- Appeal packets built with payer citations and ED documentation excerpts
- Rapid turnaround on clinical validation denials
Manage AR Intelligently
- Queue claims by denial type and payer impact
- Target resolution to meet 20-day AR cycles
Hidden Breakpoints That Erase ED Revenue
Revenue often disappears in ED workflows long before billing starts.
- Critical care delivered but time not logged → 99291 denied
- EKG performed but no signed report → 93010 rejected
- Observation stay coded without order → denial for necessity
- Trauma activation documented but not charged → revenue lost
- Attending not linked to encounter → professional fee erased
- Follow-up filed as new encounter → payer flag
- Wrong POS for freestanding ED → claim bounced
- Delayed chart closure → timely filing window missed
Preferred MB identifies and patches these breakpoints with intake retraining. EHR mapping. and pre-audits.
Are Workflow Gaps Silently Costing You ED Revenue?
Run this 5-point check — if you say yes to 2 or more. leakage is happening.
You Save Lives – We Secure Your ED Reimbursement
Emergency medicine providers stabilize patients under pressure. Preferred MB ensures that lifesaving services convert into compliant. payable claims.
We align ED workflows with payer requirements so no encounter is left behind.
Clinical Scenario
A patient presents with acute chest pain requiring rapid evaluation.
- EKG performed and reviewed in real time
- Labs and CT angiogram ordered for ACS rule-out
- Patient admitted for further monitoring and treatment
Billing Scenario
Documentation and medical necessity must align with high-level coding.
- 99285 validated against documented MDM complexity
- EKG 93010 billed with signed interpretation
- Diagnostic testing linked to necessity for payer compliance
Clinical Scenario
A septic patient arrives in shock and requires intensive intervention.
- Intubation performed to stabilize the airway
- Central line inserted for resuscitation and vasopressors
- 80 minutes of continuous critical care delivered
Billing Scenario
Accurate coding ensures full capture of time and procedures.
- 99291 applied with documented time attestation
- 99292 added for additional 30-minute intervals
- Intubation and line placement billed separately with proper modifiers
Clinical Scenario
A stroke alert is activated for a patient with acute neurological symptoms.
- CT head ordered and interpreted immediately
- Neurology consult initiated in the ED
- Thrombolytic medication administered within window
Billing Scenario
High-complexity coding reflects both urgency and interventions.
- 99285 supported with documented high-level MDM
- tPA administration coded for reimbursement
- Bundling edits cleared before claim submission
Clinical Scenario
A motor vehicle collision patient arrives requiring trauma response.
- Trauma team activation documented at arrival
- Chest tube placed to manage a thoracic injury
- 90 minutes of critical care provided in the ED
Billing Scenario
Trauma encounters require precise coding to avoid missed revenue.
- Trauma activation charge submitted with documentation support
- 99291 applied with correct time tracking
- Chest tube CPT billed with payer-specific compliance rules
How We Support Every Emergency Care Model
Hospital Emergency Departments
- Coordinate physician and facility billing
- Prevent APC and CPT conflicts
Freestanding Emergency Centers
- Validate place-of-service logic unique to freestanding EDs
- Apply payer edits before submission
Urgent Care / ED Hybrids
- Separate urgent vs emergency visits in shared EHRs
- Prevent systemic downcoding
Trauma Centers
- Capture activations. procedures. and critical care in one workflow
Programs After Audit or Vendor Change
- Rebuild AR queues
- Recover revenue left unresolved under prior vendors
Revenue Results You Can Measure in Any Emergency Department (ED) Setting
Emergency departments operate in diverse environments — from hospital-based trauma centers to freestanding EDs. Preferred MB applies payer-specific logic and compliance rules tailored to each setting so claims leave the system clean and ready for payment.
Managing high-volume encounters and aligning professional and facility claims.
- Apply APC reconciliation to prevent overlaps
- Validate attending attribution for every visit
- Track observation and admission orders for necessity compliance
- Flag payer edits tied to ED levels and bundled services
97.3%
Clean claim rate after payer-specific edits applied
Ensuring payer compliance where coverage and POS codes often differ.
- Validate place-of-service coding unique to freestanding facilities
- Confirm commercial payer requirements before submission
- Prevent denials linked to non-hospital emergency sites
- Apply separate logic for urgent care vs ED-level claims
95.8%
First-pass approval rate for freestanding ED claims
Protecting revenue in shared facilities where urgent and emergency visits overlap.
- Categorize encounters correctly to prevent systemic downcoding
- Reconcile documentation against presenting symptoms and MDM
- Separate urgent care coding from ED-level coding within shared EHRs
- Monitor payer edits for repeated visit frequency
94.9%
Clean claim rate on hybrid urgent care/ED encounters
Capturing every reimbursable service in high-acuity emergencies.
- Reconcile trauma activations with ED records
- Validate and log all critical care minutes with attestation
- Ensure procedures like intubation or chest tube placement are billed separately
- Apply payer logic for bundled trauma-related codes
96.4%
First-pass approval rate for trauma and critical care claims
ED Performance Before and After Preferred MB
Metric | Before Preferred MB | After Preferred MB |
Denial rate on 99291 Critical Care | 22% | 7% |
Average AR cycle | 40 days | 18 days |
Trauma activation charge capture | Missed frequently | 97% capture rate |
EKG claim approvals | Frequent denials | 96% first-pass approval |
Monthly revenue leakage per physician | $1,200+ lost | Documented $0 loss |
Want These Results In Your ED?
Lower denials. faster AR. zero leakage. Count on Preferred MB as the best emergency medicine billing company, which delivers measurable performance lifts for emergency medicine practices.