How do you handle Advance Beneficiary Notices for non-covered genetic and toxicology testing?

At order entry, our medical necessity engine checks the ordered test and diagnosis combination against payer LCD/NCD policy. If coverage is unlikely, the system automatically generates an ABN with the correct GA/GZ modifier guidance and routes it for patient signature before specimen processing.

Can the system manage CLIA certification numbers across multiple lab locations?

Yes. Each draw site, reference lab, and performing laboratory location is mapped to its own CLIA certificate number, and the system automatically applies the correct CLIA number to claims based on where the test was actually performed, preventing CLIA mismatch rejections.

What happens when a high-volume batch contains a systemic formatting error?

Our batch validation layer scans every claim in a submission file before transmission, isolates claims with structural or coding errors, and holds only those for correction, so a single formatting issue no longer delays or rejects an entire day's submission.

How are reflex tests and add-on orders billed correctly?

Reflex testing rules are configured per payer and per panel. When an initial result triggers a reflex test, the system automatically generates the appropriate add-on CPT code with correct date-of-service and medical necessity linkage to the triggering result.

Does the platform support molecular and genetic testing prior authorization?

Yes. For molecular pathology and genetic panels requiring prior authorization, our clearance engine identifies the applicable payer policy, compiles the required clinical documentation, and tracks authorization status through to claim submission.

How do you handle Z-code or PLA (Proprietary Laboratory Analyses) code requirements?

Our charge engine maintains a current PLA and Z-code crosswalk, automatically mapping proprietary branded assays to the correct PLA code required by Medicare and participating commercial payers, preventing rejections for outdated CPT mappings.

Can the system identify duplicate test orders to prevent compliance issues?

Yes. Our pre-billing engine flags duplicate orders for the same analyte within payer-defined frequency limitations (such as repeat lipid panels within 24 hours), preventing both compliance exposure and unnecessary claim denials.

Laboratories PM & RCM Software

Laboratories Practice Management and RCM Billing, Built to Perform

Automate CLIA-compliant panel bundling, ABN capture, and high-volume claim batching. See why laboratories practices choose Unlimited Systems for practice management and RCM software.

Why Laboratories billing is different

Clinical and reference laboratories operate at extreme transaction volume, processing thousands of daily orders across chemistry, hematology, molecular, and toxicology panels. Generic billing tools cannot keep pace with NCCI panel-bundling logic, CLIA certification requirements, and the constant churn of medical necessity policies, leaving labs exposed to mass denials and compliance risk.

A single requisition can contain dozens of individual analytes that must be correctly bundled into comprehensive metabolic panels, lipid panels, or reflex molecular tests, while non-covered or experimental tests require a signed Advance Beneficiary Notice before the specimen is even processed. Without automated CLIA-aware scrubbing tied directly to the order, labs routinely overbill panel components separately, miss ABN capture windows, and face six- and seven-figure repayment demands during payer audits.

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6,500+ specialty providersSOC 2 certified

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HOME SPECIALTIESClinical & Reference Laboratory RCM Software

Trusted Payer & EHR Integration Partners

Designed Around How Your Laboratories Practice ACTUALLY Works

Our connected workflows are built to make you and your work easier to do and increase your revenue.

Visit-ready

Keep authorization and coverage aligned before the appointment is booked.

Claim-ready

Validate laboratories codes, modifiers, and documentation before submission.

Practice-ready

Give teams one view of denials, margin, and A/R priorities.

Real Laboratories Practices, Real Results

See how laboratories groups across the country use Unlimited Systems to lift collections, cut denials, and reclaim staff time.

Featured Practice

Laboratories Partners of the Midwest

Columbus, OH14-provider group practice

“Unlimited Systems gave our laboratories billing team the specialty-specific automation we could never get from a generic platform. First-pass claim acceptance climbed fast.”

- Director of Revenue Cycle

23%

Fewer denials

11 days

Faster A/R

Calculate Your RCM Revenue Leakage

Drag the sliders to estimate how much unrealized cash remains locked in your current specialty billing cycles before optimization.

Model your current claim volume

Adjust both inputs to match your practice.

Monthly specialty claims1,500

200 claims15,000 claims

Average claim value$250

$80 value$3,500 value

Estimated annual revenue recovered

$315,000

Calculated using a 7.0% reduction in write-offs from rejection recovery, pre-authorization verification, and drug-waste capture.

Monthly invoiced volume: $375,000
Standard industry loss: $31,875

Unlimited Systems Guarantee: Fully integrated bi-directional EHR triggers maintain first-pass bill submission scores above 98.6% across regional payer rules on day one.

Review my results

See your recovery estimate

Enter your work email to unlock your estimated annual recovery.

See Your Results Immediately5/55/54.8/5

One platform for every laboratories workflow

Eight connected capabilities, grouped around the way your practice works.

Front office

Keep registration and appointment calendars in sync.

Patient intake Scheduling

Before the visit

Verify coverage and catch charge risk early.

Financial clearance Charge validation

Revenue cycle

Post payments, route denials, and prioritize A/R.

Payment and denials A/R management

Practice intelligence

See margin, performance, and value-based results.

Analytics Value-based care

The Laboratories suite

Every part of the laboratories revenue cycle, in one system

Each module is configured for the codes, modifiers, and payer rules laboratories teams work with, not adapted from generic billing software.

Laboratories Patient Intake SoftwareValidate test orders against payer medical necessity policies and trigger ABN forms for non-covered analytes at accession.Laboratories Scheduling SoftwareCoordinate draw site collections, courier pickups, and reference-lab send-out routing on one operational calendar.Laboratories Financial Clearance SoftwareCross-check diagnosis codes against Local Coverage Determinations for each ordered test before specimen processing begins.Laboratories Charge Validation SoftwareAutomatically consolidate individually ordered analytes into the correct comprehensive or organ-specific panel codes.Laboratories Payment Posting SoftwarePost batch remittances across thousands of line items with automatic exception flagging for partial denials.Laboratories AR Management SoftwareGroup denials by reason code and payer so billing teams can resolve systemic issues across entire batches at once.Laboratories Analytics SoftwareTrack reimbursement yield per test, panel, ordering provider, and reference lab send-out partner.Laboratories Value-Based Care SoftwareAggregate preventive screening test costs and outcomes for value-based and ACO laboratory contracts.

The cost of generic billing

You went into laboratories to treat patients, not to chase claims

These are the places laboratories 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 workflow

Common laboratories revenue leaks

Unbundling errors where individually billed analytes trigger NCCI edits against comprehensive panel codes.
Missing or invalid Advance Beneficiary Notices for non-covered or experimental genetic and toxicology tests.
High-volume batch claim rejections from a single formatting error cascading across thousands of specimens.
CLIA certification mismatches between ordering provider, performing lab, and billed location on multi-site networks.

Challenges we solve for laboratories

The work that generic platforms leave to your staff is the work laboratories margin actually turns on.

Panel Bundling Logic

Real-time bundling engine consolidates analytes into the correct panel code before claim generation.

ABN Compliance

Automatic medical necessity check flags non-covered tests at order entry and generates the ABN for signature.

Multi-Site CLIA Tracking

CLIA number is automatically matched to the performing facility for every specimen, network-wide.

Legacy software vs. Unlimited Systems

See why laboratories practices move off general-purpose billing platforms.

CRITERIA

LEGACY SYSTEM COMPROMISE

UNLIMITED SYSTEMS VALUE

Panel Bundling Logic

✕Bills individual analyte codes separately, triggering NCCI edits and post-payment recoupments.

✓Real-time bundling engine consolidates analytes into the correct panel code before claim generation.

ABN Compliance

✕Relies on front-desk staff to manually identify non-covered tests and obtain signatures.

✓Automatic medical necessity check flags non-covered tests at order entry and generates the ABN for signature.

Multi-Site CLIA Tracking

✕Claims submitted under mismatched CLIA numbers across draw sites and performing labs cause rejections.

✓CLIA number is automatically matched to the performing facility for every specimen, network-wide.

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.

Get a Demo Benchmark Your Current Workflow

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

Specialty rules and connected data keep your team focused on the exceptions that need judgment.

Verify before the visit

Coverage and authorization stay tied to the order.

Validate specialty charges

Code, unit, and modifier checks happen before filing.

Work the right accounts

Denials and A/R are ranked by value and filing risk.

Care team in scrubs walking through a clinic corridor

35%less manual workflow time

One platform

The rest of the platform your laboratories practice runs on

The same connected system handles the operational work that sits either side of billing.

Patient Intake

Digital intake, eligibility, and demographic capture before the visit.

Explore Patient Intake

Patient Scheduling

Smart calendars and resource scheduling across providers and locations.

Explore Patient Scheduling

Financial Clearance

Automated eligibility checks and prior authorization management.

Explore Financial Clearance

Charge Validation

Pre-claim scrubbing for coding, modifiers, and compliance accuracy.

Explore Charge Validation

Built for laboratories

Follow one laboratories patient from intake to payment

Eight 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 us

Frequently asked questions

Our scrubber maintains the current NCCI procedure-to-procedure edit table and automatically consolidates individually ordered analytes, such as glucose, BUN, creatinine, and electrolytes, into the correct comprehensive metabolic panel code before the claim is generated, preventing component-level denials.

New to revenue cycle terminology? Browse our healthcare RCM & billing glossary.

We Love Hearing From Our Users

Practices like yours, on what changed after moving to Unlimited Financials.

EXPLORE PRODUCTS GET A DEMO

★★★★★4.8/5

★★★★★5/5

“

I'd love to set up a call to talk about SCOA, and the success we've had with Unlimited Financials.

Sam Wheeler

CFO, SCOA

“

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

“

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

“

I would recommend Unlimited Financials to other specialty practices.

Michelle Leandri

CEO, NEPA

“

We transitioned to Unlimited Financials in 2024... the team and platform are absolutely amazing.

Gina

Administrator, 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 Bernacchi

Accounts Receivable Coordinator, COAS

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