Medical Billing for Hospitals, ERs, Urgent Care and Large Groups
We bill for hospitals, emergency departments and freestanding ERs, urgent care networks, and large groups and health systems. Solo practices are still served, but our pages and processes are written for larger organizations first.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026
Which Type of Organization Are You?
Pick the page that matches how you bill most of your volume. The four types below differ mainly in claim form, payer mix and how often out-of-network payment is the issue.
| Organization | Main claims | Where to read more |
|---|---|---|
| Hospitals | Facility claims on the UB-04, plus professional claims on the CMS-1500 | Hospitals |
| Emergency departments and freestanding ERs | Facility and physician claims, often out-of-network | Emergency departments |
| Urgent care networks | High-volume professional claims across many sites | Urgent care networks |
| Large groups and health systems | Many TINs, NPIs and EHRs under one roof | Large groups and health systems |
What Do We Do the Same Way for Every Client?
Every client gets the same controls: eligibility checks before claims are built, claims sent within 24 hours of charge entry, and denials worked within 48 hours. We measure the result by clean claim rate and the share of revenue recovered from denials and old A/R.
For out-of-network payment, we run open negotiation and federal IDR from first notice to final payment for every client type. See the No Surprises Act hub for the process, and the services hub for the full list of what we can take on.
How Does Nucleus Align Work with Each Type of Client?
We learn your claim forms, payers and systems first, then take on the services you choose inside your own EHR, clearinghouse and payer portals. Each workflow is aligned with verified team experience, standard claim validation, reconciliation controls and performance monitoring.
Our team works from Vancouver, BC, Dubai, UAE and Islamabad, PAK, with a US registered office in Richmond, KY. Every client has a Business Associate Agreement, and all staff have HIPAA training and NDAs.
To see how this fits your organization, book a call.
Common Questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01Who does Nucleus Align work for?
We work for hospitals, emergency departments and freestanding ERs, urgent care networks, and large groups and health systems. These are the organizations our processes and pages are built around. Each type has its own page in this section with the claims and payer issues we handle for it.
02Do you work with solo practices?
Yes, solo practices are still served. We have not written a page for them first because our lead work is facility billing, out-of-network recovery and multi-site operations. A solo practice can use the same services. Book a call to see whether the fit is right.
03What is the difference between billing for a hospital and billing for an ER group?
A hospital bills facility charges on the UB-04, with professional claims on the CMS-1500 for employed physicians. An independent ER physician group bills only professional claims, and often faces more out-of-network payment disputes. Read the hospital and emergency department pages for how each is handled.
04Is No Surprises Act work only for ERs?
No. We run open negotiation and federal IDR for every client type, from first notice to final payment, alongside applicable state pathways. Emergency departments see it most often, but hospitals, urgent care networks and large groups use it too. See the No Surprises Act hub.
05Which EHRs do you work in?
We work in your existing EHR rather than asking you to change. Each EHR, clearinghouse and payer portal workflow is aligned with verified team experience, standard claim validation, reconciliation controls and performance monitoring. The EHR hub lists the systems we work in.
06Do you bill for specific specialties?
Yes. We cover 46 specialties, including emergency medicine and urgent care. Specialty pages explain the codes, payer rules and denial patterns that matter for each. Browse the specialties hub, or start from your organization type on this page.
07Can we start with one service at one location?
Yes. You can begin with a single service or a single site and widen the scope later. You do not need to move the whole organization at once. The services hub lists everything we can take on, and a call will settle the starting scope.
08How do I know which page applies if I am more than one type?
Use the page that matches most of your claim volume, then read the others for the parts that apply. A health system with an ER and urgent care sites, for example, would read large groups and health systems, then the ER and urgent care pages.
See How This Fits Your Organization
Book a call and tell us which type you are.