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Keep authorization and coverage aligned before the appointment is booked.
Streamline antiviral drug authorizations, IV antimicrobial waste billing, and viral load-driven renewal cycles. See why infectious disease practices choose Unlimited Systems for practice management and RCM software.
Infectious disease practices navigate extraordinarily complex billing environments, managing HIV prophylaxis programs, antiretroviral drug monitoring, hepatitis C cures, and high-cost IV antimicrobial therapy regimens, all under intense payer scrutiny and strict prior authorization criteria.
A single course of IV antibiotics in an outpatient infusion suite requires simultaneous authorization confirmation, drug waste tracking, nursing administration time billing, and post-treatment laboratory monitoring code sequencing. Generic RCM platforms miss these multi-dimensional claim layers entirely.


Trusted Payer & EHR Integration Partners













Our connected workflows are built to make you and your work easier to do and increase your revenue.
Keep authorization and coverage aligned before the appointment is booked.
Validate infectious disease codes, modifiers, and documentation before submission.
Give teams one view of denials, margin, and A/R priorities.
Long-acting antiretrovirals and specialty biologics are transforming ID billing.
Where revenue is at risk
Cabenuva monthly or bimonthly injections split between Part B and Part D depending on administration site.
How the platform addresses this
| Drug | Code | Route | Channel | Cost | PA | Billing notes |
|---|---|---|---|---|---|---|
| Cabenuva (cab + rilpivirine) | J0740 / J2350 | IM | Part B | $22K/yr | Yes | Monthly or bimonthly; refrigerated; scheduling critical. |
| Sunlenca (lenacapavir) | J0222 | SQ/oral | Part B/D | $42K/yr | Yes | Twice-yearly SQ; payer policy evolving. |
| Vancomycin (IV) | J3370 | IV | Part B | Varies | Sometimes | OPAT; weight-based dosing and trough levels required. |
| Cefepime (IV) | J0692 | IV | Part B | Varies | No | OPAT antibiotic; infusion duration documentation critical. |
| Beyfortus (nirsevimab) | Q2056 | IM | Part B/VFC | $500/dose | Sometimes | RSV prophylaxis; payer coverage rapidly evolving. |
Cabinet integration: ID practices running OPAT services depend heavily on cabinet integration. Weight-based antibiotic dosing makes partial vial wastage routine, and without ADC-to-EHR linkage, JW modifier compliance is hard to maintain at scale.
Routine infectious disease work clears itself. Your team sees only what needs their judgment.
Specialty practices describe, in their own words, what changed after moving to Unlimited Systems.

“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.”
- CEO
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Every infectious disease capability, grouped around the way your practice works.
Register, schedule and clear patients before the visit.
Turn documented care into clean claims and work denials.
Post payments, collect patient balances and work open AR.
Measure performance, report it and manage quality programs.
Automation, workflow, integration and the platform underneath.
That's putting it nicely based on what we hear every day.
A support line that never picks up. An overseas call center that's never heard of your account. Errors nobody catches until the denial shows up. We're Midwest-based, not offshore, and the team that answers already knows your account. Practices that switch tend to wish they'd done it sooner.

“I would recommend Unlimited Financials to other specialty practices.”
Michelle LeandriCEO, NEPA
“We transitioned to Unlimited Financials in 2024... the team and platform are absolutely amazing.”
GinaAdministrator, FOUR
“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 BernacchiAccounts Receivable Coordinator, COAS
Each module is configured for the codes, modifiers, and payer rules infectious disease teams work with, not adapted from generic billing software.
These are the places infectious disease practices most often lose revenue when their billing platform wasn’t built for the work. Unlimited Systems closes each one with rules configured for your specialty.
Review your workflowCommon infectious disease revenue leaks
The work that generic platforms leave to your staff is the work infectious disease margin actually turns on.

See why infectious disease practices move off general-purpose billing platforms.
You don't have to be actively replacing your current system to have a useful conversation with Unlimited Systems. Many infectious disease practices talk with us months before a contract renewal or system evaluation to understand where OPAT billing, long-acting antiretroviral scheduling, 340B documentation, and culture documentation may already be showing up.
A conversation can help identify where OPAT administration coding, Cabenuva schedule-based dispensing, Part B versus Part D channel decisions, and 340B compliance documentation may be putting revenue at risk.
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.
That concern is valid, specialty practice operations are too important to disrupt. A conversation with Unlimited Systems doesn't mean an immediate rip-and-replace. We help teams evaluate workflows, identify gaps, and build a realistic path forward based on specialty, volume, payer mix, locations, integrations, and internal readiness.
Most specialty teams are already stretched thin. That's why the evaluation should focus on where the largest operational burden exists today, prior authorization, denials, charge capture, reporting, manual reconciliation, or payer-specific follow-up. The goal isn't to add work. It's to understand where better systems can remove it.
“Good enough” can still hide revenue leakage. Many practices aren't losing revenue because claims aren't being submitted, they're losing it through preventable denials, underpayments, missed modifiers, incomplete documentation, delayed authorizations, manual workarounds, and limited visibility into payer performance.
Unlimited Systems isn't designed to replace the expertise of your billing team. It's designed to give them better tools, cleaner workflows, better visibility, and fewer manual workarounds. Strong teams still need technology that helps them prioritize the right work, catch issues earlier, and reduce preventable rework.
Cash flow continuity is one of the biggest reasons to evaluate carefully and early. Unlimited Systems can help practices understand potential risk areas before a transition plan is ever built, including claim flow, authorizations, charge capture, payer rules, reporting, and operational dependencies.
Change management matters. The right platform should simplify daily work, not create unnecessary complexity. Unlimited Systems focuses on specialty workflows that align with how teams already manage authorizations, charges, denials, documentation, and financial follow-up.
Reporting is often the first visible symptom of a deeper workflow issue. If leadership can't clearly see denial trends, underpayments, authorization delays, payer behavior, or staff workload, it's harder to know what to fix. Unlimited Systems combines workflow tools with Power BI analytics to help leaders see where performance is improving and where revenue is still at risk.
That's a smart approach. A conversation with Unlimited Systems can help identify the financial case before a buying decision. Common areas to evaluate include denial reduction, staff efficiency, underpayment detection, charge capture improvement, prior authorization turnaround, and reduced manual reconciliation.
Specialty practices often depend on EHRs, clearinghouses, payment tools, drug workflows, and reporting systems. Unlimited Systems is designed to act as a connected financial workflow layer that helps reduce fragmentation, not add more disconnected work.
That caution is healthy. Automation should make decisions easier to see, not harder. Unlimited Systems is designed to surface why a claim is flagged, which payer rule applies, and where a human should step in, so your team stays in control while routine work is handled for them.
You don't need to be ready to buy to have a useful conversation. Many practices start by comparing their current workflows against what specialty-specific revenue cycle technology can support. That gives leadership a clearer view of what to fix now, what to plan for, and what questions to ask before the next renewal.
Specialty rules and connected data keep your team focused on the exceptions that need judgment.
Coverage and authorization stay tied to the order.
Code, unit, and modifier checks happen before filing.
Denials and A/R are ranked by value and filing risk.
The same connected system handles the operational work that sits either side of billing.
Digital intake, eligibility, and demographic capture before the visit.
Explore Patient IntakeSmart calendars and resource scheduling across providers and locations.
Explore Patient SchedulingAutomated eligibility checks and prior authorization management.
Explore Financial ClearancePre-claim scrubbing for coding, modifiers, and compliance accuracy.
Explore Charge ValidationEight stages, one record. Nothing is rekeyed between systems, so a detail captured at the front desk is still there when the claim goes out, and when the remittance comes back.
Walk the workflow with usWe support both commercial insurance and AIDS Drug Assistance Program (ADAP) billing pathways, correctly sequencing payer coordination rules to protect medication access for patients.
Yes. Our platform supports OPAT billing with nursing administration time codes, drug supply units, IV catheter maintenance claims, and required laboratory monitoring follow-ups.
Absolutely. We maintain CPT and HCPCS vaccine administration codes for international travel panels, yellow fever, typhoid, and multi-dose hepatitis A/B series billing.
The JW modifier allows Medicare reimbursement for the unused portion of a single-dose drug vial that cannot be saved. For high-cost IV antibiotics like daptomycin, vancomycin, and cefazolin, our system automatically calculates the difference between the ordered vial size and administered dose, generating separate JW modifier line items to recover waste revenue that typically goes unclaimed in standard billing systems.
Our lab result integration layer monitors incoming CD4 count and viral load results from connected laboratory systems. When results cross payer-defined thresholds for antiretroviral therapy continuation or regimen change, the system automatically initiates the renewal authorization workflow, populating the required clinical evidence before staff would otherwise know a renewal is needed.
HCV DAA regimens like Mavyret, Epclusa, and Harvoni require complex prior authorizations documenting genotype, fibrosis score, prior treatment history, and prescriber specialty. Our clearance engine maintains payer-specific step-therapy criteria for each DAA, auto-populates authorization requests from EHR documentation, and tracks the 8–12 week treatment course with automated mid-treatment lab monitoring alerts.
Under the ACA, Truvada and Descovy for PrEP must be covered with zero cost-sharing by most commercial plans. Our intake engine flags PrEP-eligible patients, verifies the plan's PrEP coverage tier, and routes claims correctly to prevent cost-sharing applications. For Medicaid patients, we track state-specific PrEP formulary requirements and prior authorization pathways.
Yes. We support HIV genotypic resistance testing (CPT 87901, 87906) and integrase resistance testing (CPT 87900), verifying that the ordering provider documentation includes the clinical indication (treatment failure, new HIV diagnosis), confirming prior authorization when required, and sequencing the resistance assay code with the viral load (CPT 87536) to present a complete clinical picture for payer review.
New to revenue cycle terminology? Browse our healthcare RCM & billing glossary.
Practices like yours, on what changed after moving to Unlimited Financials.
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.
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.
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.
Unlimited Financials has allowed us to extend our workforce in some areas due to the workflow efficiencies and given a better patient experience.
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.
Using Unlimited Systems has allowed us to get a much better handle on our AR and claim management.
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.
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.
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.
Unlimited Financials has allowed us to extend our workforce in some areas due to the workflow efficiencies and given a better patient experience.
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.
Using Unlimited Systems has allowed us to get a much better handle on our AR and claim management.
Connect with a specialized Infectious Disease RCM expert for a personal workflow walkthrough, and see where your current setup is creating avoidable revenue risk.