How do you handle OPAT and home infusion billing?

We verify payer rules for home infusion, map the correct infusion/administration CPTs versus drug billing, capture management time and remote monitoring encounters, and attach required clinical documentation to support claims.

Will you start prior authorizations for high-cost antimicrobials and biologics?

Yes. We initiate prior authorizations at order time using payer-specific templates, collect necessary clinical attachments, track approvals and expirations, and re-open workflows for renewals.

Can you help with vaccine and immunization clinic billing?

Yes. We manage seasonal CPT/HCPCS selection, administration coding, payer-specific vaccine rules, and bulk clinic reconciliation to prevent miscoding and denials.

How do you support telehealth and remote OPAT monitoring?

We document modality and patient consent, map telehealth codes correctly per payer rules, capture remote monitoring encounters, and integrate device/infusion data into the medical record for claim support.

How quickly will we see improvement after implementing your workflows?

Many practices observe measurable reductions in denials and faster reimbursements within 60–90 days after implementing intake validation, OPAT-specific scrubs, and structured documentation workflows.

Infectious disease medical billing for complex diagnoses and infusion treatments - Talk to an Expert button

Infectious Disease Billing Services

Specialist billing for complex care, infection by infection
Infectious disease care mixes cognitive medicine, high-value diagnostics, complex drugs, and often home-based therapy (OPAT). At Sirius Solutions Global we blend ID-aware billing expertise with AI-assisted scrubs and human oversight so your practice captures every appropriate dollar while protecting patient relationships and compliance.

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Our Infectious Disease Billing Services

Designed especially for infectious disease specialists, we offers complete billing and RCM solutions:

1. Medical Coding & Documentation Support

For infectious diseases, infusions, and telehealth, use ICD-10, CPT, and HCPCS codes.
To lower mistakes and expedite claim submission, AI-assisted coding technology.
Thorough documentation review guarantees compliance with payer standards.

2. Claims Submission & Denial Prevention

To all major payers, electronic claim submission (EDI).
Root cause resolution techniques and denial analysis.
Real-time claim tracking with diligent follow-up.

3. Patient Billing & Collections

Online payment gateways and unambiguous patient comments.
Automatic balance reminders.
Kind collection to keep patients happy.

4. Hospital & Infusion Billing

Expertise in hospital inpatient and outpatient billing.
Billing for wound care, infusion treatments, and long-term antibiotic therapies.
Handling codes for protracted, time-based services.

5. Telehealth Billing Services

Appropriate application of telemedicine codes and modifiers.
Meeting of commercial payer and CMS requirements.
Incorporation with EHR and telehealth systems.

6. Prior Authorization & Credentialing

Managing previous approvals for sophisticated medications and procedures.
Provider credentialing under commercial, Medicare, and Medicaid payers.

Who We Serve

We provide billing services for:

Independent infectious disease specialists
Group practices
Hospital-based infectious disease consultants
Telemedicine providers
Clinics offering infusion and wound care services

Why Infectious Disease Billing is Complex

Managing infectious disease billing presents particular challenges that frequently result in claim denials or delays if not handled carefully. These include:

Complicated Coding: Conditions like HIV/AIDS, hepatitis, tuberculosis, and other acute or chronic illnesses require several ICD-10-CM and CPT/HCPCS codes.
Hospital-Based Services: Cooperation between inpatient and outpatient invoicing, as infectious disease experts frequently provide consultations.
Telehealth & Remote Consultations: Many infectious disease practitioners provide care through telemedicine; hence, accurate coding and modifier application are needed.
Prolonged Treatments & Infusions: Billing for lengthy intravenous antibiotic therapy, wound care, and infusion services calls for accurate paperwork and time-based coding.
Frequent Prior Authorizations: Many therapies and expensive medications require prior authorization, which, if not handled proactively, causes delays.
Compliance Requirements: Insurance companies and CMS closely watch infectious disease practices for fraud prevention, medical need, and precise coding.

Infographic outlining hospice billing workflows from pre-admission checks and daily documentation to coding, claim scrubbing, submission, and denial resolution.

Practical hospice workflows

Use these as process text or internal SOPs.

Pre-admission check: Verify Part A, note hospice election date, confirm admitting MD certification.
Day-of documentation: Nurse visit notes capture skilled nursing needs, symptom control, and orders that justify the chosen level of care.
Daily coding: Assign revenue/Q-codes per day; validate occurrence span codes for benefit windows.
Pre-submit scrub: AI checks for inconsistencies; flagged claims sent to hospice coder.
Submission & monitoring: Claims filed; payment and remits monitored daily.
Denial resolution: Automated routing, templated appeals with clinical packet, and manual escalation for high-value or complex issues.

(Key claim/revenue code reference sheet: Medicare & MAC resources.)

AI-driven infectious disease billing: real-time coding and denial prediction

AI-Powered Infectious Disease Billing

We at Sirius Solutions Global see the billing of tomorrow driven by artificial intelligence (AI). Our AI-driven products include:

Find documentation holes before claims are filed..
Suggest precise codes in real time.
Follow payer behavior to forecast and so avoid refusals.
Offer financial transparency analytic dashboards.

This make sure that we not only identify issues but also address them and keep them fixed.

Benefits of Choosing Sirius Solutions Global

Partnering with us helps your infectious disease clinic in:

Increased Revenue: Rise in reimbursement rates and underpayment lowering.
Faster Payments: Faster payments come from accelerated claim processing enabled by AI-driven workflows.
Reduced Denials: Preventative measures taken against rejections lessen their amount, as proactive audits do.
Regulatory Compliance: Keep following payer rules, HIPAA, and CMS.
Specialty Expertise: The committed team concentrated on invoicing for infectious illnesses.
Advanced Technology: Automated coding, AI-driven billing, and dashboards for analytics are examples of advanced technology.
Focus on Patients: Free your staff from administrative burdens to allow them to fully devote themselves to patient care.

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Partner with Us Today

Billing for infectious diseases requires accuracy, compliance, and advanced technology to ensure the right reimbursements and steady cash flow. Sirius Solutions Global offers a specialized billing system for infectious disease practices fueled by artificial intelligence, supported by experienced coders, and meant to reduce rejections while maximizing profit.

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