Emergency medicine is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. An emergency department (ED) is also known as an accident & emergency department (A&E), emergency room (ER), emergency ward (EW), or casualty department. The ER is a medical treatment facility specializing in emergency medicine – the acute care of patients who present without a prior appointment, either by their means or by an ambulance. The emergency department can be a part of a hospital or a primary care center.
Emergency departments are fast-paced environments where care is delivered quickly depending on the patient’s condition’s criticality. Further, ED does not deal with one specialty per se. ED provides Medical services across specialties. It also requires close coordination of services from when a patient enters an ambulance or an ED facility to discharge, working with multiple clinical practitioners.
Typical Issues in getting reimbursed for ED services
Typical issues with ED billing are:
Missed Charges or high incidence of DNFB(Discharges not fully billed) is due to emergency departments’ fast-paced nature, further compounded by a lack of understanding of clinical documentation responsibilities.
Finding great ED coders. ED coders have dual responsibility for accurate coding and identifying DNFB cases. They need to work with physicians to reduce DNFB, and possess the ability to understand trends and patterns in clinical documentation and charges is essential.
Credentialing issues. Often, Emergency Departments require specialist physicians. Ensuring the credentialing of most of the regular specialists with common payers in the region will improve the reimbursements you receive.