Lyric Launches Emergency Department Program to Improve Facility E/M Coding Accuracy
Lyric launched its new Emergency Department Program to help health plans control rising ED facility costs through accurate, consistent, and transparent level determinations.
The program uses a structured, policy-aligned framework to assess each facility E/M claim at the appropriate level. Leveraging clinical logic based on emergent diagnoses, patient services, and complicated conditions, the program ensures defensible and consistent outcomes.
Health plans can easily configure rules and thresholds to match their reimbursement policies, operational goals, and provider relationships—while staying aligned with CMS and ACEP guidance.
Built on Lyric’s proven payment accuracy infrastructure, the program deploys quickly through existing Lyric integrations, requiring minimal IT effort.
Once live, real-time analytics and expert consultation help plans measure impact, benchmark provider behavior, and continuously optimize performance.
“As ED coding intensity continues to rise, health plans need support - not guesswork. Our Emergency Department Program uses clinically grounded criteria to ensure each claim reflects its true complexity and aligns with each health plan’s unique needs,” says Dr. Meera Atkins, Chief Medical Officer at Lyric. “We built this solution to help plans make confident decisions and strengthen provider trust through transparency.”
Product Highlights
Automated Pre-Pay Editing: Ensures accurate, defensible facility E/M coding before payment—reducing costly rework and overpayments.
Comprehensive Clinical Evaluation: Applies structured logic across diagnoses, services, and patient condition to assess true visit complexity.
Plan-Configurable Framework: Aligns with your reimbursement policy and provider strategy for consistent, policy-driven results.
Transparent Analytics & Reporting: Empowers health plans to track program impact, identify trends, and benchmark provider behavior.
Full-Service Support Model: Includes analytics, reporting, and expert consultation to guide continuous performance optimization.
Ready to ensure accurate, defensible emergency department reimbursement?
Visit the Emergency Department Program Page or Contact Us to learn how Lyric can help you reduce ED costs without adding administrative friction.
About Lyric
Lyric is an AI-first platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce cost of care that benefits payers, providers, and patients. Lyric is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be 2025 Best in KLAS for Pre-payment Accuracy and Integrity and is HI-TRUST and SOC2 certified.