Pain management and spine practicesdeserve answers, not dashboards.
Multi-site pain management organizations run Integy for scheduling and HST Pathways for surgical records. The same patient has a different ID in each one. Prior auth timelines are not mapped to the surgical schedule. Cancellations are tracked but never decomposed. Prexisio fixes all of it.
This is where Prexisio started
In 2019, a multi-site pain management organization in Tampa, Florida had a surgical cancellation rate of 30%. The COO stopped all other analytical work and directed everything toward one question: why — and how do we get it under 10%?
Answering it required building the patient identity bridge across Integy, HST Pathways, and Telcor — three systems, three different patient IDs for the same person. Nobody had ever connected them.
We built the scheduled-to-perform funnel from scratch and decomposed every cancellation by window, location, referral source, payer, and prior authorization status. For the first time, leadership could see not just the rate — but the cause.
The revenue integrity work that followed surfaced a $2M underpayment gap across active payer contracts that had never been reconciled against actual payments.
30%
Cancellation rate at engagement start
<10%
COO target — achieved through root cause decomposition
$2M+
Underpayment gap found in payer contract reconciliation
The diagnostic built here
Every Prexisio pain management diagnostic is built on what was learned in that engagement — the field names, the patient identity logic, the cancellation taxonomy, the prior auth linkage. We are not building it from scratch for your organization.
What the diagnostic covers for pain management
The diagnostic is calibrated to the specific operational reality of multi-site pain management — the systems, the cancellation drivers, the prior auth complexity, and the payer mix.
Prior auth as the #1 cancellation driver
D3In pain management, prior authorization denial is the leading cause of 48-hour surgical cancellations — but most organizations are not tracking auth approval timelines against the surgical schedule. D3 maps every surgery in the next 30 days to its auth status. CRITICAL cases flagged 5 days before the procedure.
Cancellation decomposition by window and cause
D1 + D2A 25% cancellation rate looks the same whether it is driven by date-of-service no-shows or 48-hour prior auth denials. The fix is completely different. D2 decomposes every cancellation by window, location, referral source, payer, and reason code — so the intervention is targeted, not organization-wide.
Referral source quality — volume vs. net revenue
D6Some referring providers send high volume but low-margin cases with above-average cancellation rates. D6 ranks every referral source by volume, cancellation rate, and net revenue per case — so BD resources go to the relationships that produce the best surgical outcomes.
Spinal cord stimulator and implant tracking
D2 + D7SCS and implant procedures have longer prior auth timelines, higher case values, and more complex scheduling requirements. The diagnostic tracks implant procedure volume, cancellation rates, and payer reimbursement patterns separately from general pain management cases.
Multi-site clinic and ASC scheduling complexity
D1Patients move between clinic and ASC locations. The same patient has a different ID in Integy (clinic) and HST (ASC). Before any cross-location analysis is possible, those identities must be resolved. The patient identity bridge is the foundation of every other deliverable.
Payer contract vs. paid reconciliation
D7 + D8Pain management payer contracts are complex and often favorable — but only if someone is checking whether payers are honoring them. D7 digitizes your contracts and runs the reconciliation. Underpayments ranked by dollar amount. Prioritized appeal list for the billing team.
Systems we work with in pain management
We have verified the table names, field names, and filter values in these systems. The patient identity bridge between Integy and HST Pathways is already built. We are not starting from scratch.
Primary EMR — scheduling, referrals, charges, encounters
ASC platform — surgical records, clinical timing, OR utilization
Secondary EMR at some multi-site organizations
ERA payments, claims, payer remittance data
Find out what your cancellation rate is costing your practice.
Three inputs. Thirty seconds. A specific monthly dollar amount.