Pain management billing that gets every procedure approved. Injections, nerve blocks, ablations and the visits around them, each authorized and billed to its payer’s rules.
The AI drafts the codes from the procedure note and your provider approves them. From there our billing team takes the claim to the deposit.
- Pain practices of 1–20 providers
- Works inside your EHR
- Commercial, Medicare, Medicaid
What we fix
What pain management practices miss. We bill all of it.
Every claim, start to finish
From your note to your bank. Every step on the record.
You see who touched each claim, and when.
Your dashboard
Every number, live. Down to each visit.
Collections, denials, days to payment and open AR.
Try the live demo
Denials and appeals
We fight every denial. Even the $58 ones.
In pain management, the usual ones are prior authorization for injections and ablations, session limits per spinal region, and relief scores missing from the notes.
How we fight denials- 01Fix and resendSame claim
- 02Appeal with the recordsBilling manager signs
- 03Chase claims with no replyStatus, then a call
- 04Check what was paidAgainst your contract
Start with a free pain management audit.
Free · no obligation · no patient data in the form.
Start the audit- Sign a short BAAWe email it to you.
- Upload two reports12 months of 835s and your AR aging.
- Get your practice profileDenials ranked by dollars, walked through on a call.
The rules we bill by
Pain management billing runs on approvals, limits and relief scores.
These are the Medicare rules our team bills by. Commercial and Medicare Advantage plans often follow them, with their own prior authorizations on top.
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4 per region
Epidural injections, four sessions a year
Medicare covers up to four epidural steroid injection sessions per spinal region in a rolling 12 months, under CT or fluoroscopy. A repeat needs at least 50% relief, or 50% better function, lasting at least three months.
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80% · two blocks
Two diagnostic blocks before an ablation
Radiofrequency ablation of the facet nerves needs two diagnostic medial branch blocks first, each giving at least 80% relief of the patient’s main pain, recorded in the note.
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2 a year · 1–2 levels
Ablations, twice a year per region
No more than two ablation sessions per spinal region are paid in a rolling 12 months, at one or two levels a session. A repeat needs at least 50% improvement lasting at least six months.
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Modifier 25 · 80%
A visit on procedure day
A visit billed with a procedure needs modifier 25 and a note that shows separate work. From January 1, 2027, Medicare pays the lower-paid of a modifier 25 visit and a same-day 0-day procedure at 80%.
Sources: Epidural steroid injections LCD (L39240) · Facet joint interventions LCD (L38773) · 2027 Physician Fee Schedule final rule. Each Medicare contractor publishes its own version of these LCDs. Rules as of November 2026; commercial plans and Medicaid set their own.
Questions owners ask.
Do you handle prior authorizations for procedures?
Yes. We check whether each plan needs approval for the injection or ablation, request it with the records it asks for, and follow it until it’s approved or denied, before the procedure date.
What happens when a procedure is denied?
We fix and resend what can be fixed, and appeal the rest with the records. Our billing manager signs every appeal. See how we fight denials.
Do you bill workers’ comp and no-fault?
Commercial, traditional Medicare, Medicare Advantage, Medicaid and TRICARE. Workers’ comp and no-fault later, state by state, New York first.
Which EHR do we need?
None in particular. We work inside the system you chart in today, through our clearinghouse connection, your vendor’s API or exports you control.
What will this cost us?
3.5–5.5% of collections · annual agreement · 45-day opt-out. Payers pay you directly, into your bank account. We invoice our fee monthly from posted collections. See pricing.
How long does switching take?
About 30–45 days, with a parallel run before go-live. Your EHR, bank account and payer contracts stay the same. See how switching works.
Will this add work for our providers?
No. They chart the way they do today and approve each visit’s codes. Everything after that is ours.
What if it isn’t working for us?
If it isn’t working in your first 45 days, you can leave, no questions asked. After that it’s an annual agreement, which sets out the notice and how your files come back to you.
Every procedure, approved and paid. Let’s look at yours.
3.5–5.5% of collections · annual agreement · 45-day opt-out
Rather start with your numbers? Get a free billing audit.