Who We Serve/Pain Management

Find where your pain practice is leaking revenue.Know what to do next.

Pain management practices lose revenue through preventable denials, underpayments, and cancellation-driven procedural capacity loss. The challenge is knowing where the issue is concentrated, why it appears to be happening, and which revenue integrity actions should be considered first.

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This is where the work started.

In 2019, a multi-site pain management organization in Tampa, Florida was trying to understand why surgical cancellations were running high and which operational issues were affecting procedural volume.

Answering that question required connecting scheduling, surgical, and supporting operational records into a clearer view of the scheduled-to-performed funnel. Leadership needed to see not only that cancellations were happening, but where they were happening and what appeared to be driving them.

The work also expanded into revenue integrity. Contracted allowed amounts were compared against actual payments so leadership could see reimbursement gaps that had not been visible through normal reporting.

30%

Cancellation rate at engagement start

<10%

Leadership target for surgical cancellations

$2M+

Underpayment gap identified through contract review

Why this matters for pain management

Pain management revenue leakage often sits across scheduling, authorization, claims, payment, and procedural capacity. Leadership needs the pieces connected clearly enough to understand what deserves attention first.

What pain management practices need to see clearly.

The goal is not more reporting. The goal is a clearer answer across denials, underpayments, cancellations, and the operational patterns that affect revenue integrity.

Preventable denial leakage

Denial Prevention

Pain management practices often face denial patterns tied to prior authorization, eligibility, documentation, coding, payer requirements, and front-end workflow issues. The value is knowing which denials are recurring, preventable, and financially meaningful enough to address first.

Prior authorization risk

Denial Prevention

Authorization issues can affect both reimbursement and scheduled procedural volume. Leadership needs visibility into where authorization breakdowns appear to be creating denial risk, cancellation risk, or both.

Payer reimbursement variance

Revenue Integrity

A paid claim does not always mean the payment was right. Pain management practices need to see where payers, CPT codes, procedures, providers, or locations may be showing inconsistent reimbursement patterns.

Underpayment exposure

Revenue Integrity

Underpayments can remain hidden when claims and remittance data are reviewed one transaction at a time. The goal is to identify where earned revenue may not have been fully collected and what deserves deeper review.

Cancellation-driven revenue loss

Cancellation Impact

Cancellation rates are easy to report. The harder question is where cancellations are concentrated, what procedural capacity is being lost, and which scheduling issues may be affecting revenue integrity.

Multi-site procedural visibility

Practice Visibility

Pain management patients often move across clinics, providers, procedures, and ASC settings. Leadership needs a connected view across scheduling, claims, payments, and operational activity to understand where leakage is concentrated.

The questions leadership should be able to answer.

Pain management practices usually have the data. The gap is turning the data into clear answers leadership can act on.

Denials

Which denial categories are recurring and preventable?
Which payers, locations, providers, or workflows appear to be driving denial leakage?
Which denial issues should leadership address first?

Underpayments

Where did the practice earn revenue but collect less than expected?
Which payers, CPT codes, procedures, or providers show reimbursement variance?
Which payment gaps deserve finance or revenue cycle review?

Cancellations

Where are cancellations creating unused procedural capacity?
Which appointment types, providers, locations, or procedures are most exposed?
Which scheduling issues may be affecting revenue integrity?

The work starts with the data already available.

Pain management practices should not need to adopt another software system just to understand where revenue integrity is breaking down. The starting point is the data already produced by the practice.

Prexisio uses the practice’s claims, payment, scheduling, and supporting operational files to identify where leakage appears concentrated and what leadership should examine first.

Scheduling Data

Appointment activity, cancellations, reschedules, provider schedules, and procedural capacity

Claims Data

Submitted claims, CPT codes, payer activity, service locations, providers, and denial patterns

Payment Data

Allowed amounts, paid amounts, remittance activity, payer variance, and reimbursement patterns

Operational Files

Supporting context such as authorization status, locations, procedure types, and internal workflow data when available

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