Systems Design
Systems Design (aka Systems Design West) is a privately held EMS billing services provider founded in 1989, delivering full-service ambulance billing, EMS billing, and cost-recovery services to fire departments, EMS agencies, and public hospital districts across the Western United States.
- Company typePrivate
- Founded1989
- HeadquartersPoulsbo, United States
- Headcount1–10
- GTM typeB2B
- OfferingServices
What Systems Design does
Systems Design (DBA: Systems Design West) is a privately held EMS billing services provider founded in 1989 and headquartered in Poulsbo, Washington. The company delivers full-service ambulance billing, EMS billing, and cost-recovery billing to municipal fire departments, EMS agencies, fire districts, and public hospital districts across the Western United States. Its offerings cover all transport levels (BLS, ALS, specialty care, and non-transport EMS incidents) plus non-transport cost-recovery billing for motor vehicle accidents, false alarms, rescue responses, hazmat cleanup, FireMed, and operational inspections. The company runs dedicated departments for Patient Services, Insurance Services, and Compliance, and bills under individually negotiated multi-year contracts likely structured as a percentage of collections.
The underlying technology stack centers on a proprietary 5010-compliant EMS billing platform with NEMSIS-compliant data transmission that ingests incident reports directly from third-party Fire/EMS software (with scanned paper forms as a fallback). Supporting modules include a secure client-facing Web Reporting and Inquiry portal for 24/7 account access and custom reporting, a branded patient-facing portal (EMSPatient) for account explanations and credit card payments, and a ChartRequest-integrated HIPAA-compliant records exchange for third-party medical, billing, and balance verification requests. Compliance is anchored by an in-house Certified Ambulance Compliance Officer and staffed by Certified Ambulance Coders.
Go-to-market is sales-led and enterprise-oriented, targeting municipal and public-sector clients through direct outreach, industry referrals, and existing-client recommendations. Marketing channels include a professional website, dedicated phone sales lines, segmented email inboxes (general inquiries, attorney requests, cost recovery), and the client login portal. The company emphasizes customized setup, provider enrollment, policy administration, staff training, and ongoing account management as core onboarding deliverables. Revenue figures are not publicly disclosed, and no funding rounds, M&A, or institutional ownership have been recorded.
Systems Design firmographics
Firmographics- Name
- Systems Design
- Legal name
- Systems Design
- Website
- https://systemsdesignems.com
- Company type
- Private
- Founded year
- 1989
- Operating status
- Operating
- Headcount range
- 1–10 employees
- Short description
- Systems Design (aka Systems Design West) is a privately held EMS billing services provider founded in 1989, delivering full-service ambulance billing, EMS billing, and cost-recovery services to fire departments, EMS agencies, and public hospital districts across the Western United States.
- Ownership category
- akta.pro rank
Systems Design industry classification
Industry- Product category
- EMS Medical Billing Services
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- EMS Billing, Revenue Cycle & Compliance Services (HLAFANAM)
- akta.pro secondary industry
- Incident Reporting, Deficiency Management & Compliance Documentation Services (Digital Logs/Records) (BPABAHAN)
Keywords
Where Systems Design is headquartered
LocationHeadquarters
- HQ city
- Poulsbo
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Systems Design business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales
Revenue model
- Ambulance Billing Services: Full-service ambulance billing and EMS billing services for transport claims at all levels of service. Revenue is generated through administrative fees, likely structured as a percentage of collections or per-transaction fees for billing, follow-up, and collection services.
- Cost Recovery Billing: Billing administration for fire agencies to recover costs from motor vehicle accidents, false alarm responses, rescue responses, illegal burns, FireMed, operational inspections/permits, and hazmat cleanup. Administrative fees are collected from recovered funds.
- Patient Services and Collections: Patient billing services including statement preparation, payment processing, charity applications, payment plans, and collections follow-up for uninsured patients.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom billing services tailored to client needs |
Go-to-market motion2 records
Distribution channels3 records
Marketing channels4 records
Systems Design product offering
Product offeringCore offering
Systems Design provides full-service ambulance billing and EMS billing for fire departments, EMS agencies, ambulance districts, and public hospital districts, covering claims submission at all service levels, follow-up, collections, patient communications, payment processing, and reporting. The offering is delivered through a proprietary 5010 compliant EMS billing platform with NEMSIS compliant data transmission, a secure client web portal, and a dedicated in-house compliance program led by a Certified Ambulance Compliance Officer. Adjacent cost recovery services recover funds from motor vehicle accidents, false alarms, rescue responses, illegal burns, FireMed, operational inspections/permits, and hazmat cleanup.
Product overview
Systems Design offers a unified EMS billing platform built around its proprietary 5010 Compliant EMS Billing Software, complemented by multiple integrated service modules. The core platform handles all ambulance billing, EMS incident billing, and motor vehicle accident response billing. Supporting modules include: Web Reporting and Inquiry Portal (client-facing portal for real-time account access and reporting), Patient Web Page via EMSPatient (patient-facing portal with payment and communication features), NEMSIS Compliant Data Transmission (electronic data import from EMS software), ChartRequest Records Portal (HIPAA-compliant records exchange), and Cost Recovery Services (fire agency billing for hazmat, rescue, false alarms, and related responses). The company also provides dedicated departments for Patient Services, Insurance Services, and an in-house Compliance Department to support the entire billing operation.
Differentiator
Problem solved
Functional benefit
Products and services
- Ambulance Billing Services Full-service ambulance billing covering all levels of service, including ambulance transport and EMS incident response without transport. Includes claim submission in all formats, receipt guarantee system, provider enrollment setup, policy administration, and online access to month-end reports. Targeted at EMS agencies, fire departments, and public hospital districts throughout the Western United States.
- Cost Recovery Services Billing services for fire agencies to recover costs associated with fire response including motor vehicle accidents, false alarm response, rescue response, illegal burns response, FireMed billing administration, operational inspection/permit billing, and hazmat cleanup response. Includes all billing, follow-up, and communication with involved parties per client resolution. Targeted at fire departments and fire agencies seeking to recover costs for non-transport services.
- Proprietary 5010 Compliant EMS Billing Software Systems Design's core EMS billing software platform that is 5010 compliant and agile, allowing quick adaptation to changes in the EMS billing arena while maintaining high customization for individual client needs. Backed by infrastructure providing maximum security, reliability, and efficiency. Targeted at EMS agencies and fire departments contracting for ambulance billing services.
Quantifiable outcome
- Revenue increase of $40,000 in first year compared to previous flat percentage billing
- +2 more outcomes
Companies that use Systems Design
Customer profileNamed customers8 records
Segments4 records
Ideal customer profiles3 records
Systems Design technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
Feature6 records
Systems Design partnerships and signals
Strategic signalScale indicators3 records
Recent moves5 records
Expansion highlights5 records
Systems Design competitors and assessment
Company assessmentDirect peers
- ESO Solutions: ESO provides EMS EHR, billing, and analytics software for EMS agencies and fire departments across the U.S., overlapping directly with Systems Design's core ambulance-billing software and reporting offering.
- ImageTrend: ImageTrend provides EMS electronic patient care reporting, billing, and data platform software to fire and EMS agencies, competing with Systems Design on the technology platform layer and increasingly on managed billing services.
- Emergitech: Emergitech delivers third-party EMS billing and accounts-receivable management services to ambulance providers and fire-based EMS agencies, making it one of the closest niche comparables to Systems Design's service model.
- RevSpring: RevSpring specializes in healthcare patient billing, statements, payments, and patient engagement workflows for providers—adjacent to Systems Design's EMS Patient portal and patient services capabilities but at much larger scale across multiple provider types.
- ZOLL Data Systems: ZOLL's EMS software division, built around its 2019 acquisition of Digitech Computer Systems, offers full-service EMS billing software and RCM directly to ambulance and fire agencies—head-to-head competition with Systems Design for the same customer base.
Others
- FirstWatch: FirstWatch supplies near-real-time EMS data analytics and quality improvement software to fire/EMS agencies, making it an adjacent rather than direct peer that often shows up alongside Systems Design in agency tech stacks.
- Witt O'Brien's: Witt O'Brien's is an emergency management and disaster recovery consulting firm adjacent to the cost-recovery part of Systems Design's offering, particularly for municipalities recovering costs tied to large-scale incidents.
- CentralSquare Technologies: CentralSquare provides public-safety CAD, RMS, and EMS-related software suites (including the legacy TriTech/Sungard Public Sector product lines) to municipalities. It does not directly bill EMS claims but is an ecosystem participant often in the same procurement decisions.
Broad incumbents
- Optum (UnitedHealth Group): Optum, formed from UnitedHealth's acquisition of Change Healthcare, operates the largest healthcare revenue cycle management and analytics platform in the U.S., capable of serving EMS agencies and competing with Systems Design for larger regional accounts.
- Waystar: Waystar is a large healthcare RCM and patient payment platform used by hospitals and specialty providers; while EMS is not its core vertical, its scale and pricing power allow it to compete in any provider billing RFP.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
Systems Design social profiles
Digital presenceSystems Design compliance and trust
Trust signalCompliance1 record
Systems Design financial estimates
Financial estimateRevenue estimate
Valuation estimate
Systems Design leadership team
Management profileNumber of profiles
Profiles1 record
Systems Design funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Systems Design M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Systems Design
What does Systems Design do?
Systems Design provides full-service ambulance billing and EMS billing for fire departments, EMS agencies, ambulance districts, and public hospital districts, covering claims submission at all service levels, follow-up, collections, patient communications, payment processing, and reporting. The offering is delivered through a proprietary 5010 compliant EMS billing platform with NEMSIS compliant data transmission, a secure client web portal, and a dedicated in-house compliance program led by a Certified Ambulance Compliance Officer. Adjacent cost recovery services recover funds from motor vehicle accidents, false alarms, rescue responses, illegal burns, FireMed, operational inspections/permits, and hazmat cleanup.
Is Systems Design a public or private company?
Systems Design is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Systems Design founded?
Systems Design was founded in 1989. It employs 1 to 10 people.
Where is Systems Design based?
Systems Design is headquartered in Poulsbo, United States, in the North America region.
How does Systems Design make money?
Three revenue lines are on record. Ambulance Billing Services are the primary driver. The others are cost Recovery Billing and patient Services and Collections.
Who are Systems Design's main competitors?
Direct peers on record are ESO Solutions, ImageTrend, Emergitech, RevSpring and ZOLL Data Systems. Others are FirstWatch, Witt O'Brien's and CentralSquare Technologies. Broad incumbents are Optum (UnitedHealth Group) and Waystar.
Does Systems Design have an API?
No public API is recorded for Systems Design.
What industry is Systems Design in?
Systems Design's product category is EMS Medical Billing Services. Its primary akta.pro industry code is HLAFANAM, EMS Billing, Revenue Cycle & Compliance Services, with a secondary code of BPABAHAN, Incident Reporting, Deficiency Management & Compliance Documentation Services (Digital Logs/Records). Its SIC code is 7370.