Infectious Disease Specialists
Specialized Billing for OPAT, HIV Treatment, Sepsis Management, and Anti-Infective Infusion Therapy
Infectious disease billing is one of the most challenging specialties in healthcare. It’s wrapped with countless medications and ever-changing coding rules, where every condition and treatment demands precise documentation. A single misstep in OPAT billing triggers denials and revenue leakage. Our infectious disease medical billing experts handle HIV care, infusion therapy, and long-term antibiotic billing with experience and precision.
98%
from
88%
Clean Claim Rate
↑ +10 pts
10%
from
16%
Denial Rate
↓ −37.5%
$550K
from
$400K/month
Monthly Revenue
↑+37.5%
Stabilized
from
high & unstable
AR Days
↓ Reduced
Source: Chicago Infectious Disease case study — results from Feb 2026 to Apr 2026 (last 3 months of performance data). Read the full case study →
— OPAT Expertise
Infectious disease practices are often underpaid because payer models don’t fully account for the complexity of consults and long-term care management. When billing is handled by teams unfamiliar with OPAT and ID-specific coding, it leads to missed charges and unnecessary denials. Our infectious disease billing company helps you with:
— End-to-End RCM
We provide turnkey Infectious Disease (ID) Practice RCM services that elevate your revenue performance, shorten A/R days, and empower your practice to grow sustainably and profitably.
Accurate and Specialty-Specific Coding
Our certified ID coders understand the complexity of infectious disease billing services. Our experts are knowledgeable in applying ICD-10 codes, HCPCS (J-codes), and CPT E/M codes (99202–99215).
Prior Authorization and Eligibility Checks
Our team manages prior authorizations for expensive anti-infectives, biologics, and infusion therapies to minimize claim rejections. We also conduct eligibility verifications in advance to prevent revenue leakage and update patients about co-pays.
Compliance and Documentation Support
From Tele-ID billing and modifier -25 accuracy to wastage documentation and audit readiness, we ensure your claims meet every payer and regulatory standard. We protect your practice from denials, penalties, and compliance risks.
We go beyond traditional denial resubmission. Our AR team identifies the root causes of rejections, resolves them at the source, and enhances your billing workflow to prevent recurring issues.
Revenue Optimization and KPI Tracking
What gets measured, improves. Our RCM dashboards track key KPIs, including clean claim rate, net collection rate, and days in accounts receivable (A/R). We give you real-time insight into your financial health.
Practice/Provider Credentialing
Obtaining credentials with insurance payers can be one of the most time-consuming aspects of running an infectious disease practice, and every delay directly impacts your cash flow.
Ready to Optimize Your ID Practice Revenue?
Our infectious disease billing specialists understand the complexity of your practice and manage your ID Practice Revenue Cycle Management diligently.
— Sub-Specialties
Behind every OPAT patient are multiple moving parts: doctor visits, high-cost antibiotic drugs, and infusion services. If even one piece is billed incorrectly, you lose revenue. That’s where we come in.
We handle the full picture, making sure your physician visits are properly documented, your drug claims use the right J-codes (including wastage with JW/JZ), and your infusion services are billed accurately.
Tuberculosis Treatment Billing Services
HIV Billing Services
Antibiotic Therapy Billing Services
Sepsis Billing Services
Travel Medicine Billing Services
COVID-19 Treatment Billing Services
Vaccine Administration Billing Services
Antimicrobial Stewardship Program (ASP) Billing Services
Wound & Post-Surgical Infection Billing Services
— Solutions
| Challenge | Our Solution |
|---|---|
| Denials for HIV, sepsis, and complex infection coding | Accurate ICD-10 coding & sequencing (A41.x, R65.20/21) aligned with 2026 CMS guidelines to prevent denials and undercoding. |
| High-cost antibiotic J-code billing errors | Precise J-code, unit billing, and JW/JZ wastage documentation for drugs like vancomycin, ceftriaxone, and daptomycin—so you recover full drug revenue. |
| OPAT billing across multiple services | End-to-end OPAT claim coordination (E/M, infusion, drug billing) with correct place-of-service and authorization handling. |
| HIV care undercoded or misbilled | Optimized HIV billing (E/M 99213–99215, CD4, viral load) with proper documentation and Ryan White compliance. |
| Missed inpatient consult revenue | Capture every ID consult visit (99221–99223, 99231–99233) with correct complexity and documentation. |
| Sepsis coding impacting reimbursement | Detailed sepsis coding audits to ensure correct severity capture and maximum DRG reimbursement. |
| Uncaptured ASP (antimicrobial stewardship) revenue | Structured ASP billing workflows for consults, telehealth, and hospital contracts; fully CMS-compliant. |
| Slow payments & growing A/R | Proactive denial management + AR follow-ups to accelerate cash flow and reduce write-offs. |
— Our Advantage
Running a specialized infectious disease practice requires strategic decisions, and outsourcing your billing & coding to ID experts isn’t just smart. It’s essential for maximizing revenue and minimizing headaches.
Powerful Technology Integration
Seamless integration with your current EHR/EMR (Epic, Cerner, Allscripts).
Transparent Reporting
Detailed billing reports for inpatient infectious disease consults for financial insights.
Proven Revenue Growth
Our clients consistently report higher reimbursement rates and fewer claims errors.
Infectious Disease Medical Billers & Coders
AAP-certified infusion therapy billing experts for claims management.
100% Secure Infectious Disease Billing Services
Follow HIPAA guidelines to safeguard patient information and maintain confidentiality.
— Choose Your Plan
Transparent Pricing With No Hidden Fees
Starter
For Solo & Small Practices
*Based on collections
Most Popular
Growth
For Group Practices & Clinics
*Based on collections
Enterprise
Hospitals & Large Systems
Volume-based pricing
— Proven Expertise in
50+ EHR/EMR/PMS
— Here's What Most Practices Ask
Frequently Asked Questions
Infectious disease specialists provide many cognitive/consultative services (E/M-type). The recent CMS/CPT revisions (including G2211, add-on codes such as G0545, and updated documentation rules) require practices to update their documentation practices, including medical decision-making, time, and complexity, to avoid claims being undervalued or denied.
When you outsource infectious disease billing to a team specializing in ID, you capture revenue in three specific areas that generalist billers miss: (1) OPAT and anti-infective J-code accuracy — including wastage documentation that recovers the full cost of partially used drug vials; (2) inpatient consultation coding at the correct complexity level for ID-specific cognitive work; and (3) G2211 add-on code capture on established patient visits. ID-specialized outsourced billing typically recovers 15–20% more revenue than generalist billing teams managing the same claim volume.
We optimize OPAT billing by coordinating E/M visits, infusion administration (CPT 96365–96366), and anti-infective drug J-code billing with accurate unit calculations and JW/JZ wastage documentation. This ensures you capture the full reimbursement for high-cost IV antibiotics while reducing denials and billing gaps across care settings.
Yes, we specialize in HIV and sepsis billing compliance. We ensure accurate E/M coding for HIV management, correct lab billing (CD4, viral load), and proper coordination with Ryan White Program requirements. For sepsis, we apply precise ICD-10 coding and severity sequencing (A41.x, R65.20, R65.21) to support medical necessity, prevent audits, and maximize reimbursement.
Your Infectious Disease Revenue Cycle Deserves Better
Schedule a consultation with our ID billing specialists. We’ll audit your current cycle and show you exactly where revenue is being left behind.
