Case Study: First Med Inc. achieves paperless, faster billing turnaround and reduced mailing costs with Esker on Demand

Taking paper out of monthly billing runs

First Med Inc., founded in 1988 as a small family-owned ambulance service on Virginia’s Eastern Shore, has grown into the largest private ambulance group in the Southeast, transporting over 100,000 patients annually with more than 300 employees across multiple offices. The company was spending roughly two weeks each month manually checking 5,000 patient statement pages, then folding, stuffing and preparing envelopes for mailing—time-consuming, error-prone work that diverted staff from higher-value tasks and slowed billing turnaround.

First Med implemented Esker on Demand, enabling direct upload from its billing software into Esker’s platform where staff can review, accept or cancel individual statements, track progress via Document Manager, and catch missing address data to reduce returned mail. The automation preserved First Med’s existing process while cutting manual labor and postage handling, reduced statement review to about one week, improved visibility into mail status, and freed employees to focus on more productive work.

First Med Inc.

Matt Ellis

AR Manager, First Med Inc.