Precision Pain Management
Key Results
1The Challenge
As a pain management practice, Precision Pain faced uniquely complex coding and prior authorization requirements. Their previous EMR lacked pain-specific templates, and the practice was losing an estimated $400K annually to undercoding, missed charges, and denied prior authorizations. Controlled substance prescribing was handled through a separate system, creating workflow inefficiency and compliance risk. The two providers were spending more time on administrative tasks than patient care.
2The Solution
CareMetric AI was configured with pain management-specific templates including injection procedure notes, PDMP integration, and controlled substance monitoring. The AI-powered claim scrubber identified undercoded visits and suggested appropriate modifier usage. Integrated prescription management eliminated the need for a separate prescribing tool, and the prior authorization module automated submission for common procedures. Real-time eligibility verification prevented coverage surprises.
We recovered over $340,000 in the first year just from proper coding and reduced denials. The prior auth automation alone saved us 15 hours a week. This system pays for itself many times over.
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