6,500+ specialty providersCapture-ready
Start-stop times convert into compliant initial and sequential CPT sets.
CPT CODING & CHARGE CAPTURE VALIDATION
Charge Validation Software for Complex Medical Practices
The Leading Automated Charge Verification & Infusion Unit Validation PlatformReclaim lost infusion revenue. The engine cross-references EHR nursing logs against CPT billing hierarchies to capture forgotten administration hours, drug waste, and concurrent injections.
Why this work is different
Charge validation cross-references a completed infusion or injection session against the drafted claim. Nurses document infusion hours, drugs accessed, and residue discarded, but none of that reaches the claim unless something reads it.
If a claim goes out without add-on administration hours or waste modifier detail, the revenue is not delayed, it is gone. Multi-hour therapy sessions get billed as single-hour codes and nobody notices, because the claim pays.
Auto CPT Infusion Mapping
JW/JZ Wastage Audits
Live Correct-Coding Checks
6,500+ specialty providersSOC 2 certified
Of identified charge leakage recaptured
98.4%
Measured across specialty practices
Charge Validation Software
- Continuous matching
- CPT
- Modifier success
- 100%
- Of leakage captured
- 98.4%
Trusted Payer & EHR Integration Partners
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What Is Charge Validation Software?
Charge validation software checks every charge before it becomes a claim: that the codes match the documentation, units and modifiers are correct, drug quantities reconcile with what was administered, and payer rules are met.
It catches the errors that otherwise surface weeks later as denials or underpayments, and finds missed charges, services that were documented but never billed.
Key Considerations When Choosing Charge Validation Software
Charge accuracy is cheapest to fix before submission. Look for:
Documentation matching. Charges checked against the clinical record they came from.
Drug unit reconciliation. Administered doses, NDC units, and waste reconciled automatically.
Edit checks. CCI, bundling, and payer-specific edits applied before the claim.
Missed charge detection. Documented services without a matching charge flagged.
Work queues. Exceptions routed to coders with the reason attached.
Charge validation software that meets these criteria lifts clean-claim rates and recovers missed revenue.
Designed around the work, not bolted on
One connected workflow from the first appointment to reimbursement.
Waste-ready
Vial size and administered dose produce a verified JW modifier line.
Audit-ready
CCI edits and necessity checks run before the claim transmits.
Charge Validation Advantages
Capture Every Administered Dollar
Biologic compounds are too complex for traditional templates. The engine scrubs nursing logs and applies CPT rules before claims are generated.
CPT Time-Tracker Audits
Converts raw clinical start and stop times into compliant billing sets (96413, 96415, 96361), removing manual calculation errors.
Automated JW Residue Modifier
Reads vial selections, calculates biological waste, and appends the JW modifier so discarded drug is reimbursed.
Pre-Submission CCI Edits
Continuous evaluation against National Correct Coding Initiative rules flags duplicate claims and invalid CPT pairings immediately.
Direct Ledger Exports
Audited charges parse as double-entry general ledger lines, keeping corporate balances in step with clinical documentation.
Unlimited Financials
Inside charge validation
Intelligent Rules Engine
Always-on rules refine and update charges for the organization's specialty and payer mix, so clean claims are released faster.
Proactive Alerting
Embedded AI alerts staff to the likelihood of a claim denial based on historical trends, in time to intervene.
Clinical Integrations
Proprietary API endpoints consume clinical data from every source of activity capture, powering features like drug reconciliation.
Robust Configuration
Configuration options enable a touchless review process that limits staff intervention and reduces days to file.
Interactive charge recovery calculator
Simulate Infusion Leakage Recovery
Set your infusion patient roster, average sessions per patient per year, and the value typically missed per session to size the recovery.
Model your current infusion volume
Adjust all three inputs to match your treatment roster.
500
502,000
8
218
$180
$50$500
See your full results
Enter your work email to unlock the numbers. No call required.
See Your Results ImmediatelyGoogle5/5Gartner5/5G24.8/5
Directional estimate only — bring your own payer mix and we’ll model it properly.
The cost of generic software
Every gap here is money that was already earned
These are the places practices most often lose revenue when this part of the workflow runs on software that wasn’t built for it. Unlimited Systems closes each one with rules configured for your specialty and payers.
Review your workflowWhere the money goes
- Multi-hour therapy sessions billed as single-hour codes because add-on units were never added.
- Discarded single-dose drug written off because no JW line was ever created.
- Concurrent and sequential injections omitted from long nursing narratives.
- CCI conflicts discovered from a payer rejection instead of before transmission.
What changes on day one
The work generic platforms leave to your staff is the work your margin actually turns on.
Multi-hour sessions are frequently billed as single-hour codes.
Automated hierarchy mapping from the documented clinical timeline.
Nurses file manual secondary waste forms, and omissions are common.
Precise residual wastage captured from the dose record itself.
Post-adjudication review, issues surface only on the rejection notice.
Pre-transmit error locking that holds the claim until it is clean.
Side by side
Why Specialty Billing Demands Active Charge Validation
How standard EHR templates compare against continuous CPT charge capture validation.
Criteria
Legacy system compromise
Unlimited Systems value
Infusion add-on hoursReads start-stop values to add subsequent hours (CPT 96415) automatically.
✕Multi-hour sessions are frequently billed as single-hour codes.
✓Automated hierarchy mapping from the documented clinical timeline.
Residue waste calculationValidates single-use vial sizes against the administered dose log.
✕Nurses file manual secondary waste forms, and omissions are common.
✓Precise residual wastage captured from the dose record itself.
CCI pre-submission auditFlags duplicate and conflicting claim lines before transmission.
✕Post-adjudication review, issues surface only on the rejection notice.
✓Pre-transmit error locking that holds the claim until it is clean.
Still evaluating
Not Ready to Switch Yet? That's Exactly When to Start the Conversation.
You don't have to be actively replacing your current system to have a useful conversation with Unlimited Systems. Many specialty practices talk with us months before a contract renewal, system evaluation, or operational change so they can understand where revenue leakage, denial risk, prior authorization delays, and reporting gaps may already be showing up.
You don't have to wait until your contract is up to start evaluating your options. The best time to assess your revenue cycle technology is before renewal pressure begins. Unlimited Systems can help you understand where your current workflows may be creating avoidable denials, manual work, charge capture gaps, or reporting limitations, so you're better prepared for renewal, replacement, or future planning.
Less billing work between the visit and payment
Connected data and specialty rules keep your team on the exceptions that need judgment.
Verify before the visit
Coverage and authorization stay tied to the order.
Validate every charge
Code, unit, and modifier checks happen before filing.
Work the right accounts
Denials and A/R are ranked by value and filing risk.
35%less manual workflow time
One platform
The rest of the platform your practice runs on
The same connected system handles the operational work that sits either side of this module.
AI Healthcare Software
AI-driven automation that works every step of the revenue cycle by exception.
Explore AI Healthcare SoftwarePayment Posting & Denial Management
Auto-matched remits and denial workflows that keep AR moving forward.
Explore Payment Posting & Denial ManagementRCM & Medical Billing Software
End-to-end billing from charge to close, tuned to specialty payer rules.
Explore RCM & Medical Billing SoftwareHealthcare Accounting Software
Financial reporting and reconciliation built for healthcare's rules.
Explore Healthcare Accounting SoftwareBy Specialty
Buy-and-Bill and Charge Capture Risks by Specialty
Drug units, wastage modifiers, and infusion documentation decide whether specialty claims pay in full. See the risk in your specialty.
- OncologyWastage & Dose RoundingJW/JZ modifiers are mandatory for single-dose vials; payer dose-rounding policies vary and can erode margin.Oncology software
- RheumatologyInfusion Time Documentation96365/96366 require start and stop times; incomplete documentation leads to partial payment.Rheumatology software
- Behavioral HealthMAT Drug BillingVivitrol and Sublocade have dose and unit-count rules where errors can deny the full high-cost drug claim.Behavioral Health software
- NeurologyJW/JZ Wastage ModifiersTysabri requires wastage modifier documentation; missed modifiers can trigger post-payment audits.Neurology software
- GastroenterologyInfusion Room BillingGI infusion suites must manage drug and administration codes with precise infusion start/stop documentation.Gastroenterology software
- OrthopaedicsImplant and DME CodingImplants and DME require separate HCPCS reporting and billing tracks, with eligibility and documentation gaps driving denials.Orthopaedics software
- UrologyLHRH Agonist BillingLupron and Eligard require precise dose and duration coding; 1-, 3-, 4-, and 6-month variants each carry distinct billing risks.Urology software
- Infectious DiseaseAntibiotic Infusion BillingOPAT requires detailed administration coding and monitoring, with 96365-96368 codes carrying high importance.Infectious Disease software
- NephrologyIron Infusion BillingInjectafer, Venofer, and Monoferric have separate J-codes; dose-per-visit calculation and wastage modifiers matter.Nephrology software
- OphthalmologyHigh Volume, High StakesRetina practices may perform 50+ injections daily; a 2% coding error rate can cause $2K+ daily leakage.Ophthalmology software
- EndocrinologyBiologic Osteoporosis DrugsProlia, Evenity, and Reclast require PA, bone density documentation, and fracture risk scoring.Endocrinology software
Tailored Specialty Configurations
Specialty Specific Solutions
Each clinical specialty possesses unique operational rules and claim requirements. Search or browse our fully configured Charge Validation Software configurations below.
Infusion Care
Oncology & Hematology
Oncology Charge Validation Software
Dose-rounding rules, multi-bay scheduling, chemo-specific drug clearance, and waste modifiers tracking.
Infusion Care
Rheumatology
Rheumatology Charge Validation Software
Complex buy-and-bill workflows, real-time biological injection and infusion clearance, and J-code tracking.
Infusion Care
Cardiology
Cardiology Charge Validation Software
Cardiac device and clinic appointment matrix coordinates, interventional CPT sequences, and echo prior-auth checks.
Infusion Care
Infusion Services
Infusion Services Charge Validation Software
Advanced chair/bay slot balancing, patient duration predictive overrides, nurse-to-patient safety ratios, and EHR matching.
Surgical Suite
Urology
Urology Charge Validation Software
High-complexity outpatient procedure flows, pathology and lab synchronization, and catheterization eligibility clearance.
Surgical Suite
Dermatology
Dermatology Charge Validation Software
High-throughput check-list workflows, cosmetic vs therapeutic prior-auth rules, and biopsy modifier billing checks.
Surgical Suite
Diagnostic Imaging
Diagnostic Imaging Charge Validation Software
Modalities (MRI, CT, PET) calendar balance, specialized technician scheduling, and real-time prior-auth checks.
Infusion Care
Gastroenterology
Gastroenterology Charge Validation Software
Split facility/professional fee systems, colonoscopy screening modifier crossovers, and anesthesia codes alignment.
Surgical Suite
Neurosurgery
Neurosurgery Charge Validation Software
High-acuity surgeon modifiers, intraoperative nerve monitoring workflows, global post-op tracking, and device inclusions.
Surgical Suite
Neurology
Neurology Charge Validation Software
Support for sleep logs, EMG checklists, cognitive scoring, and complex specialized home health infusion clear pathways.
Clinical Program
Mental & Behavioral Health
Behavioral Health Charge Validation Software
Psychotherapeutic codes, medication checkers, recurring outpatient templates, and multi-state compliance matrices.
Surgical Suite
Ophthalmology
Ophthalmology Charge Validation Software
Refractive surgical billing grids, vision insurance crossovers, retina scan diagnostic checklists, and global cataract rules.
Clinical Program
Multi-Specialty
Multi-Specialty Charge Validation Software
Unified billing ledgers across multiple high-acuity departments and seamless EHR data mapping coordinates.
Infusion Care
Allergy & Immunology
Allergy & Immunology Charge Validation Software
Complex multi-vial antigen compounding logs, venom dose escalations, and rapid biological asthma injection pathways.
Infusion Care
Endocrinology
Endocrinology Charge Validation Software
Continuous glucose monitor (CGM) sensor logging, hormone infusion therapies, and complex diabetic education tracks.
Infusion Care
Infectious Disease
Infectious Disease Charge Validation Software
Outpatient parenteral antimicrobial therapy monitoring, home health nursing coordinate feeds, and J-code splits.
Infusion Care
Nephrology
Nephrology Charge Validation Software
Renal dialysis facility coordinates, erythropoiesis-stimulating agent dose-rounding logs, and Medicare ESRD compliance.
CUSTOM ENTERPRISE ENGINES
Consult Specialty EngineerNeed customized rule configuration for other clinical programs?
Unlimited Systems templates flexible operational and billing matrices for over 25+ medical specialties. We configure local and commercial medical guidelines to protect your clinical revenue flow patterns from lost claims.
Knowledge base
Frequently asked questions
Charge validation cross-references completed chemotherapy, infusion, or injection sessions against the drafted claim. Nurses document infusion hours, drugs accessed, and residue discarded. If a claim is submitted without add-on hours (CPT 96415) or waste modifier detail, that revenue is lost permanently.
New to revenue cycle terminology? Browse our healthcare RCM & billing glossary.
Hear It From Our Clients
Specialty practices describe, in their own words, what changed after moving to Unlimited Systems.
Video testimonial
Hematology and Oncology Associates of Northeastern PA
Dunmore, PennsylvaniaIndependent Hematology & Oncology
“As I look back at the transition, the support and the collaboration with the folks at Unlimited really helped make us feel at ease. We had a partner that really wanted us to be successful.”
- Michelle Leandri, CEO, Hematology and Oncology Associates of Northeastern PA
- Days in A/R shrank from 21 to 15, consistently.
- Charges go out the next day.
- Less manual work, more clean claims, and stronger cash flow.
We Love Hearing From Our Users
Practices like yours, on what changed after moving to Unlimited Financials.
“
Rated 5 out of 5
The system continues to grow with features as it should, with how healthcare changes. So, if you are looking for a company that is innovative and truly cares, I would recommend Unlimited Financials.
Ernelita Dacumos
Billing Manager, SHOM
“
Rated 5 out of 5
Unlimited Financials has been the easiest and best practice management system I have used. It is easy to navigate and do what I need to do.
Melissa Shook
Medical Biller, SHOM
“
Rated 5 out of 5
We have been on Unlimited Financials for over three years and love it. Our claims are being processed faster and more efficiently, which means we are receiving payment more quickly.
Renee Bernacchi
Accounts Receivable Coordinator, COAS
“
Rated 5 out of 5
Unlimited Financials has allowed us to extend our workforce in some areas due to the workflow efficiencies and given a better patient experience.
Mel Davies
CFO, Oregon Oncology Specialists
“
Rated 5 out of 5
Knowledge of the patient's coverage has been a game changer. The ability to verify benefits before the patient comes in has saved us on time and denials, so there is no delay in treatment.
Alisha Haslem
Patient Advocate Manager, Utah Cancer Specialists
“
Rated 5 out of 5
Using Unlimited Systems has allowed us to get a much better handle on our AR and claim management.
Erin Wilcher
Executive Director, Commonwealth Cancer Center
“
Rated 5 out of 5
The system continues to grow with features as it should, with how healthcare changes. So, if you are looking for a company that is innovative and truly cares, I would recommend Unlimited Financials.
Ernelita Dacumos
Billing Manager, SHOM
“
Rated 5 out of 5
Unlimited Financials has been the easiest and best practice management system I have used. It is easy to navigate and do what I need to do.
Melissa Shook
Medical Biller, SHOM
“
Rated 5 out of 5
We have been on Unlimited Financials for over three years and love it. Our claims are being processed faster and more efficiently, which means we are receiving payment more quickly.
Renee Bernacchi
Accounts Receivable Coordinator, COAS
“
Rated 5 out of 5
Unlimited Financials has allowed us to extend our workforce in some areas due to the workflow efficiencies and given a better patient experience.
Mel Davies
CFO, Oregon Oncology Specialists
“
Rated 5 out of 5
Knowledge of the patient's coverage has been a game changer. The ability to verify benefits before the patient comes in has saved us on time and denials, so there is no delay in treatment.
Alisha Haslem
Patient Advocate Manager, Utah Cancer Specialists
“
Rated 5 out of 5
Using Unlimited Systems has allowed us to get a much better handle on our AR and claim management.
Erin Wilcher
Executive Director, Commonwealth Cancer Center
GET STARTED
Scrub Every Infusion & Capture Forgotten Margin
Streamline CPT administration coding into GAAP-compliant ledger entries with a clinical charge capture analyst.
6,500+ specialty providersSOC 2 certified
Related billing & RCM glossary terms
Brush up on the revenue cycle terms that come up most with this part of the platform: clear, plain-language definitions from our RCM team.
Charge PostingClinical Documentation ImprovementCoding Compliance AuditDiagnosis PointerDischarge Status CodeE&M Time-Based CodingNational Correct Coding Initiative EditsCPT 96360CPT 96361CPT 96365CPT 96366CPT 96367
Browse the full RCM glossary