ED Facility Level Methodology Review
Evaluate internal policies and clinical documentation to align hospital billing with national standards, ensuring that every facility level assignment is proportionate to the patient’s clinical presentation.
How We Support Our Clients
Our approach relies on a comprehensive, multi-step process rooted in Reliable Care Organization (RCO) principles.
We evaluate whether documented interventions, including diagnostics and treatments, are proportionate to the patient's presenting acuity and treatment workflows.
We confirm that ED level assignments were executed correctly using the organization's own internal systems while ensuring those methodologies remain consistent with national industry benchmarks.
We design processes to independently assess billed E/M levels against the documented complexity of medical decision-making to ensure the intensity of service rendered is accurately reflected in the final claim.
We utilize data-driven methods to analyze the patient's final disposition in relation to the billed facility level, ensuring objective consistency between clinical outcome and reimbursement.
Ready to Strengthen Your Position?
Partner with MHMDAA's physician-led team to build defensible, evidence-based processes that withstand scrutiny at every level.