Medical Billing · Nationwide
Emergency Medicine & Hospitalists Medical Billing Services
High-acuity emergency department coding, critical care time documentation, trauma team activation charges, and No Surprises Act Qualified Payment Amount (QPA) dispute arbitration.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to emergency physician groups, freestanding EDs, and hospitalist services across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical emergency medicine & hospitalists CPT range we work: 99281–99285, 99291–99292, 99221–99223, 99231–99233.
Why emergency medicine & hospitalists billing leaks revenue
Payer downcoding of Level 5 ED visits (99285) to Level 4 (99284) using automated algorithms without regard to high-risk diagnostic testing or MDM complexity
Critical care time (99291 for first 30–74 minutes, 99292 for each additional 30 minutes) documentation clawbacks due to missing bedside time logs or non-continuous care intervals
No Surprises Act out-of-network underpayments: Commercial payers reimbursing below median in-network rates without initiating Open Negotiation or Federal IDR dispute resolution
Concurrent hospitalist and emergency physician admission day billing (99285 on same date as 99223) triggering duplicate service CARC 18/97 rejections
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Emergency Medicine & Hospitalists billing FAQ
How do you prevent algorithmic downcoding on CPT 99285?
Our certified emergency coders substantiate Medical Decision Making (MDM) using 2023 AMA guidelines, explicitly auditing high risk of morbidity, prescription drug management, and parenterally administered medications before claim dispatch.
How do you handle No Surprises Act Qualified Payment Amount (QPA) disputes?
We track the 30-business-day Open Negotiation period for out-of-network emergency claims and file certified Federal IDR arbitration requests to capture fair-market contracted reimbursement.