How are observation status patients billed differently from inpatient status?

Observation patients are billed using observation care codes which differ from inpatient subsequent care codes. Our system tracks the patient's official status for each date of service and applies the corresponding code set, automatically adjusting if a mid-stay status change from observation to inpatient (or vice versa) is documented.

What support exists for discharge day management billing?

Discharge day management is billed as 99238 (30 minutes or less) or 99239 (more than 30 minutes) based on total time spent on discharge-related activities including final exam, discussion with the patient and family, prescription writing, and coordination of post-discharge care. Our system prompts providers to document total discharge time to support the correct code.

How does the platform track transitional care management (TCM) eligibility?

After a qualifying inpatient discharge, our system opens a TCM tracking record requiring documented patient contact (phone, electronic, or in-person) within 2 business days of discharge and a face-to-face visit within either 7 or 14 days depending on medical decision-making complexity, generating the TCM claim (99495/99496) only once both requirements are met.

Can the system handle billing for hospitalist co-management of surgical patients?

Yes. Co-management arrangements where a hospitalist manages medical issues for a surgical patient are tracked with documentation supporting medical necessity for the hospitalist's involvement separate from the surgeon's global surgical package, ensuring claims aren't denied as duplicative of the surgical global period.

How are admission H&P (history and physical) visits coded?

Initial hospital care codes (99221-99223) are determined based on the complexity of the admission documentation, with our system validating that the level selected aligns with the documented problems, data reviewed, and risk, consistent with current E/M guidelines for initial hospital visits.

Does the platform support critical care billing by hospitalists?

Yes. When a hospitalist provides critical care services to a deteriorating inpatient, the system supports critical care time-based coding (99291/99292) alongside the standard subsequent care workflow, ensuring the critical care encounter is billed instead of, not in addition to, a routine subsequent visit for the same date.

How does the system handle multiple hospitalists seeing the same patient on the same day?

Our system flags same-day, same-specialty visits to the same patient and consolidates documentation to ensure only one E/M service is billed per day per group (per Medicare's same-specialty group billing rules), preventing duplicate billing denials while preserving each provider's documentation for the medical record.

Hospitalists PM & RCM Software

The Leading Practice Management and RCM Billing Software for Hospitalists

Master inpatient E/M coding, discharge management, observation status billing, and TCM follow-up. See why hospitalists practices choose Unlimited Systems for practice management and RCM software.

Why Hospitalists billing is different

Hospitalist groups bill an enormous volume of inpatient encounters every day, each requiring precise determination of admission, subsequent care, and discharge E/M levels, accurate observation versus inpatient status classification, and seamless coordination with transitional care management billing after discharge. Generic outpatient-oriented billing platforms struggle with the daily rounding cadence and status-based billing rules unique to inpatient medicine. Unlimited Systems is built around the daily rhythm of hospital medicine, from admission through discharge and into the post-acute follow-up window.

A hospitalist's daily workflow involves admitting new patients, rounding on existing patients with subsequent care visits coded based on time or medical decision-making complexity, and discharging patients with discharge day management codes that vary based on time spent. Observation status patients are billed under a different code set than inpatient status, and a status change mid-stay must be reflected accurately in billing. After discharge, transitional care management billing requires a specific sequence of patient contact within 2 business days and a face-to-face visit within required timeframes.

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6,500+ specialty providersSOC 2 certified

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HOME SPECIALTIESHospital Medicine & Hospitalist RCM Software

Trusted Payer & EHR Integration Partners

Designed Around How Your Hospitalists 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 hospitalists codes, modifiers, and documentation before submission.

Practice-ready

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

Real Hospitalists Practices, Real Results

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

Featured Practice

Hospitalists Partners of the Midwest

Columbus, OH14-provider group practice

“Unlimited Systems gave our hospitalists 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.

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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 hospitalists 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 Hospitalists suite

Every part of the hospitalists revenue cycle, in one system

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

Hospitalists Patient Intake SoftwareVerify and document inpatient versus observation status determination at the time of admission for correct initial coding.Hospitalists Scheduling SoftwareOrganize daily patient census across units and facilities to ensure every encounter is documented and coded same-day.Hospitalists Financial Clearance SoftwareTrack mid-stay status changes between observation and inpatient to ensure billing codes reflect the correct status for each date of service.Hospitalists Charge Validation SoftwareValidate subsequent care visit levels (99231-99233) and discharge day management time-based coding (99238/99239).Hospitalists Payment Posting SoftwareBatch-post daily charges across the entire rounding census, matched to facility admission and discharge records.Hospitalists AR Management SoftwareTrack the post-discharge contact and visit windows required for transitional care management billing eligibility.Hospitalists Analytics SoftwareAnalyze wRVU production, visit-level distribution, and length-of-stay trends across the hospitalist group.Hospitalists Value-Based Care SoftwareMonitor readmission rates and length-of-stay metrics tied to hospital value-based purchasing partnerships.

The cost of generic billing

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

These are the places hospitalists 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 hospitalists revenue leaks

Inpatient subsequent care visits (99231-99233) coded at lower complexity levels than documentation supports due to rushed daily rounding documentation.
Observation versus inpatient status billing errors when a patient's status changes mid-stay without corresponding billing code adjustments.
Discharge day management (99238/99239) under-billed when total time spent on discharge activities isn't fully captured.
Transitional care management (TCM) codes missed entirely when the required post-discharge contact and visit timing isn't tracked.

Challenges we solve for hospitalists

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

Subsequent Care Coding

Point-of-care complexity and time prompts ensure each subsequent visit is coded to the level the documentation supports.

Observation vs. Inpatient Status

Status change tracking automatically adjusts the applicable code set for each date of service based on documented status.

Transitional Care Management

Automated TCM workflow tracks the 2-business-day contact and required follow-up visit window to ensure eligible claims are captured.

Legacy software vs. Unlimited Systems

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

CRITERIA

LEGACY SYSTEM COMPROMISE

UNLIMITED SYSTEMS VALUE

Subsequent Care Coding

✕Daily rounding visits are coded at default mid-level codes regardless of documented complexity due to time pressure.

✓Point-of-care complexity and time prompts ensure each subsequent visit is coded to the level the documentation supports.

Observation vs. Inpatient Status

✕Mid-stay status changes aren't reflected in billing, causing claims to use the wrong code set for affected dates of service.

✓Status change tracking automatically adjusts the applicable code set for each date of service based on documented status.

Transitional Care Management

✕TCM billing opportunities are missed because the required post-discharge contact timing isn't tracked after the patient leaves.

✓Automated TCM workflow tracks the 2-business-day contact and required follow-up visit window to ensure eligible claims are captured.

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 hospitalists 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 hospitalists

Follow one hospitalists 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

Each daily rounding note is evaluated for the complexity of problems addressed and medical decision making, or alternatively the total time spent on the unit/floor that day, with the system recommending the appropriate level (99231, 99232, or 99233) based on whichever methodology yields documentation support.

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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