Visit-ready
Keep authorization and coverage aligned before the appointment is booked.
Master ESRD bundle billing, dialysis facility fee splits, and CKD progression documentation. See why nephrology practices choose Unlimited Systems for practice management and RCM software.
Nephrology practices face uniquely complex billing environments spanning outpatient CKD management, inpatient acute kidney injury consultations, vascular access procedures, and the heavily regulated ESRD Prospective Payment System bundle.
The ESRD PPS bundle consolidates over 50 previously separate services into a single per-treatment rate. Failing to properly document excluded services or correctly split professional and facility fees leads to catastrophic revenue compression that generic systems cannot prevent.


Trusted Payer & EHR Integration Partners
.png)
.png)
.png)
.png)
.png)
.png)
.png)
.png)
.png)
.png)
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 nephrology codes, modifiers, and documentation before submission.
Give teams one view of denials, margin, and A/R priorities.
ESA and iron therapy billing complexity makes dialysis-adjacent RCM uniquely challenging.
Where revenue is at risk
Aranesp and Epogen are heavily scrutinized by CMS and require hemoglobin monitoring documentation.
How the platform addresses this
| Drug | Code | Route | Channel | Cost | PA | Billing notes |
|---|---|---|---|---|---|---|
| Aranesp (darbepoetin) | J0881 / J0882 | SQ/IV | Part B | $8K/yr | Yes | Hgb threshold documentation required each visit. |
| Injectafer (ferric carboxymaltose) | J1439 | IV | Part B | $3K/course | Sometimes | Two-dose protocol; single-use vial JW required. |
| Venofer (iron sucrose) | J1756 | IV | Part B | $1K/yr | No | Multi-dose vial; partial dose tracking needed. |
| Parsabiv (etelcalcetide) | J0606 | IV | Part B | $6K/yr | Yes | 3x/week dialysis dosing; bundle exclusion critical. |
| Monoferric (ferric derisomaltose) | J1437 | IV | Part B | $2K/course | Sometimes | Newer; single-dose; JW required. |
Cabinet integration: Dialysis-adjacent nephrology practices using in-office IV therapy rely on accurate dispensing records. Without ADC integration, ESA dose tracking across visits fails audits, especially for Hgb threshold compliance.
Routine nephrology 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
Drag the sliders to estimate how much unrealized cash remains locked in your current specialty billing cycles before optimization.
Adjust both inputs to match your practice.
Enter your work email to unlock your estimated annual recovery.
Every nephrology 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.
Each module is configured for the codes, modifiers, and payer rules nephrology teams work with, not adapted from generic billing software.
These are the places nephrology 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 nephrology revenue leaks
The work that generic platforms leave to your staff is the work nephrology margin actually turns on.

See why nephrology 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 nephrology practices talk with us months before a contract renewal or system evaluation to understand where ESA documentation, iron therapy billing, lab-value support, and dialysis-related complexity may already be showing up.
A conversation can help surface where ESA hemoglobin documentation, iron infusion dosing and wastage, TSAT/ferritin lab support, and bundle-versus-fee-for-service decisions may be creating audit and denial exposure.
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 maintain a continuously updated excluded services list aligned with the CMS ESRD PPS final rule, automatically routing excluded drugs, labs, and supplies outside the bundle for separate billing.
Yes. We support home hemodialysis and peritoneal dialysis monthly capitation billing, training session codes, and remote monitoring claims for home dialysis patients.
Absolutely. Our quality module aggregates Kt/V adequacy, anemia management, and mineral metabolism measure performance and submits directly to CMS QIP registries.
CMS publishes an annually updated excluded drugs and biologicals list. Key excluded items include calcimimetics (cinacalcet/Sensipar billed as J0604), certain ESA agents above specific dose thresholds, and separately billable drugs when therapeutically required. Our excluded services engine is updated with each CMS final rule release and automatically identifies excluded items before each dialysis session claim is submitted.
Nephrologists bill monthly capitation fees (CPT 90960–90966) based on the number of dialysis sessions supervised per month, while the dialysis facility bills separately for the technical service. Our system generates the physician monthly capitation claim and tracks the session count automatically, preventing the common error of nephrologists over- or under-billing based on inaccurate session counts.
Transitional care management (TCM) codes CPT 99495 and 99496 can be billed for CKD patients discharged from inpatient status, with enhanced contact requirements and a face-to-face visit within 7 or 14 days. Our system flags CKD patients post-hospitalization, tracks the required contact timelines, and alerts providers when the face-to-face visit window is approaching to capture this frequently missed revenue.
AV fistula creation, AV graft placement, and fistulogram/angioplasty procedures require specific modifier sequences based on the access type, surgical approach, and relationship to prior procedures. Our vascular access billing module applies correct modifier -50 (bilateral), -59 (distinct procedural service), and facility/professional split rules for each procedure type.
Yes. We support inpatient nephrology consultation billing (CPT 99252–99255) for AKI management, tracking the clinical complexity level required for each code tier and confirming that the documentation supports the requested level of service. We also support AKI dialysis support billing during inpatient stays under the hospital facility's separately billable acute dialysis codes.
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.
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
Connect with a specialized Nephrology RCM expert for a personal workflow walkthrough, and see where your current setup is creating avoidable revenue risk.