EMRVerify — How It Works

EMRVerify

Trust but verify.

Patent Pending · 64/126,699 Patent Pending · 64/135,093 Patient-facing Insured or uninsured

01 — WHERE YOU START

Two ways in. One engine.

Most people arrive with a bill they don't understand. A smaller group arrives with an ambulance bill — a different code set, a different law, and no federal protection at all.

Core product

Medical bill & EOB audit

Doctor visits, labs, hospital stays, imaging, telehealth, psychiatric care.

Runs on CPT + ICD-10 + NCCI edit rules
Works with or without insurance
Caregiver mode for parents & dependents

$12 single audit · $19/mo Family Watchdog

Paid add-on

Ground ambulance audit

The one bill federal law still doesn't cover. Separate module, separate code set.

Runs on HCPCS A0-series + mileage rules
Checks level-of-service upcoding
Checks loaded-mileage inflation

Add-on tier · pricing in development

Got an ambulance bill? The module has its own site — AmbulanceVerify.com →

02 — WHAT HAPPENS

Bill in. Letter out.

Six steps. The patient never has to learn a code.

STEP 1

Upload the document

Photo or PDF of a bill, an EOB, or a patient-portal statement.

STEP 2

Read and extract

Codes, dates of service, units, modifiers, provider, and charges are pulled into a structured claim.

STEP 3

Request what's missing

If the itemized detail isn't there, a records request letter is generated citing 45 CFR § 164.524.

STEP 4

Run the checks

Every line is tested against the detection modules below.

STEP 5

Write the letter

A plain-English findings summary plus a ready-to-send dispute or appeal letter, with each finding cited.

STEP 6

Send and track

The patient emails it and gets a record of what was sent, to whom, and when.

03 — THE SUB-BRANCH

What Step 4 actually checks

The detection layer. Nine active modules, each mapped to a specific billing error pattern.

Module	Flags	Reads
UPCODE	Visit billed at a higher level than the documentation supports	CPT E/M
UNBUNDLE	One procedure split into separately billed parts	NCCI
STACK	Multiple same-day codes billed together improperly	CPT
DUPLICATE	The same service billed twice	Claim lines
PHANTOM	Service billed that has no matching record	EMR vs. bill
DOC-GAP	Documentation missing or inconsistent with the charge	EMR
UNITS	Quantity or time units inflated beyond what was delivered	Units field
MODIFIER	Modifier used to bypass a bundling edit	Modifiers
COVERAGE	Charge conflicts with the plan's own coverage policy	EOB terms

04 — Why the ambulance add-on exists

Congress passed the law. Then left one bill out.

Ground ambulance — not covered by federal law

Jan 2022The No Surprises Act takes effect, ending most surprise billing — including for air ambulances.
3MPrivately insured people are transported by ground ambulance in emergencies each year, with no ability to choose the provider.
1 in 4Of those trips may result in a surprise balance bill.
Aug 2024The federal advisory committee issues its recommendations. Federal action then stalls; the committee is now inactive.
22States have passed their own ground ambulance protections. The rest have none.
$0Specialized consumer tools auditing ground ambulance bills today.

SOURCES — No Surprises Act, Consolidated Appropriations Act 2021, eff. 01/01/2022 · Advisory Committee on Ground Ambulance and Patient Billing, Report to the Secretaries, 08/28/2024 (CMS) · Commonwealth Fund, 02/2026 · KFF Peterson Health System Tracker

05 — WHAT COMES NEXT

The roadmap, in order

Same engine, new document types. Nothing here is speculative — all of it is claimed in the provisional filings.

NOWMedical bills & EOBsBeta

NEXTGround ambulanceBuilding

THENDental billingClaimed

THENImaging & radiologyClaimed

LATERVeterinary billingClaimed

06 — THE QUESTION EVERYONE ASKS

So what do I actually get back?

Three answers, honestly ranked. Most of the value is in the first two.

You already paid it → you get refunded

A charge that was duplicated, miscoded, or never rendered is refunded to you directly by the provider.

You haven't paid yet → you stop owing it

Your coinsurance is a percentage of the charge. Inflate the code, inflate your share. Correcting it lowers what you owe — every visit, every month. This is where the recurring value is.

The insurer or Medicare was overbilled → they recover it

Those funds return to the payer, not to you. Reporting can carry a small reward. Large recoveries run through whistleblower actions, which require an attorney — not an app.