Pain Management Billing Services
Receive payment on time and in full without drawing your staff from patient care.
Billing for pain management is not only challenging but also always evolving. Uncertain income comes from image-guided interventional operations, multilevel spinal work, time-based services, repeated earlier permissions, workers’ comp, and exacting document requirements. With specialized billing that is exact, compliant, and created for the realities of current pain methods, Sirius Solutions Global brings order to the madness.
What We Do (End-to-End Pain Management RCM)
Operating as your practice extension, we offer technology that silently simplifies your day together with clear communication, specialized knowledge, and technology.
1) Eligibility & Prior Authorizations
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Insurance checks are done in real time prior to operations or visits.
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Prior auth control for RFA, SCS studies/implants, intrathecal pump investigations/implants, kyphoplasty, advanced imaging, and PT/chiro requirements.
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Documentation packing conservative therapy history, imaging, results, pain scales fast-track approvals.
2) Specialty Coding & Charge Capture
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Precise CPT/HCPCS/ICD-10 coding for:
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Epidural steroid injections (cervical, thoracic, lumbar)
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Medial branch blocks & facet joint injections (single/multi-level)
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Radiofrequency ablation (RFA): unilateral/bilateral, multi-level, cervical/lumbar
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Radio Frequency (RF) and injections into the sacroiliac (SI) joint
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Permanently implanted SCS trials (leads, pulse generators, revisions)
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Intrathecal pump testing, implantation, refills, and upkeep
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When appropriate, peripheral nerve blocks, trigger point injections, botulinum toxin
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Kyphoplasty/vertebroplasty
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When chargeable, ultrasonic/fluoro guidance.
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When appropriate, urine drug screening (UDS) and interpretation
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Accurately used modifiers (RT/LT, 50, 59/XS, XU, 26, TC, 51, and AS as needed).
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Multiple surgical decreases, global periods, and bilateral policies correctly implemented.
3) Clean Claims & Payer-Specific Edits
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AI-assisted cleaning for bundles with mismatched diagnoses, missing levels/laterality, incorrect units, or bundling issues.
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Applied before submitting to reduce reworking are payer-by-payer rule sets (LCDs/NCDs/NCCI).
4) Denial Management & A/R Recovery
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Root cause analysis for every denial category.
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Quick resubmission with corrected codes, operative note attachments, or medical necessity support.
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Concentrated recuperation for high-value treatments, including RFA, SCS, and intrathecal pump.
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Workers' compensation and automobile injury follow-through with the appropriate paperwork trail.
5) Patient Billing That’s Clear & Respectful
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Clear statements that lower confusion and call volume
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Options for payment and amiable outreach to help to increase collections without damaging patient connections.
6) Compliance & Audit Support
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Audit trails, safe data transfer, and HIPAA-compliant processes.
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Chart audits for medical need, conservative care documentation, imaging evidence, and outcomes tracking.
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For providers and employees, templates and training help to produce faster, better documentation.
Why Practices Choose Sirius Solutions Global
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Pain-management specialization (not generic billing)
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Human account managers who learn your workflows and preferences
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Practical technology that prevents errors without adding clicks
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Transparent reporting and clear KPIs you can trust
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Compliance-first mindset to keep you audit-ready
Why Pain Management Billing Is Uniquely Hard
You are not fabricating anything if you believe you are doing everything correctly but are still battling denials. Because:
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Procedures and bundling rules are difficult. Each has distinct coding, unit, and laterality requirements: facet injections vs. medial branch blocks, RFA, epidurals, SI joint injections, and kyphoplasty.
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Image guidance does not necessarily have its own separately chargeable component. Often bundled, ultrasound and fluoroscopy have specific permissions; hence, knowing when they are permissible matters.
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Past clearances reduce the speed. Often requiring thorough preapproval are spinal cord stimulators (implants and trials), intrathecal pumps, and RFA.
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NCCI edits change along with NCDs/LCDs. Diagnosis-to-procedure mapping and modifications can vary; therefore, if you do not react rapidly, you might face unexpected denials.
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Different payers Medicare, MA plans, Medicaid, commercial, VA, workers’ comp, and auto injury/liens have unique regulations and deadlines.
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Documentation level. Levels, laterality, medical necessity, start/stop times, conservative care history, and imaging results must be absolutely solid.
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UDS and opioid compliance. Urine drug screening and controlled-substance management have strict billing and documentation requirements.
A claim can be rejected or downgraded if one component modifier, laterality, level, or diagnosis specificity is missing.
Results You Can Expect
Every practice begins with a different baseline, but typical results from cleanup and workflow coordination include:
Better first-pass acceptance results from presubmission edits and improved coding.
Faster approvals and fewer revisions mean shorter AR cycles.
Recovered income from focused appeals on expensive treatments
Lower denial rates for bundling and medical necessity
Before beginning, we will assess your present metrics and predict changes.
Procedures & Scenarios We Handle Every Day
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Cervical, thoracic, and lumbar ESIs (interlaminar, transforaminal, and caudal)
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Bilateral, multi-level facet/medial branch blocks
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Radiofrequency ablation (RFA) with proper level count rules
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Injections for the sacroiliac joint and radio frequency
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Trials and implants using spinal cord stimulators; modifications, removals
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Trial, implant, refills, and programming: intrathecal medication distribution
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Kyphoplasty or vertebroplasty combined with imaging and diagnostic matching
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Trigger point injections, peripheral nerve blocks
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UDS with appropriate frequency and documentation, screening versus confirmation.
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Telehealth for follow-ups and medication management when covered
Documentation: What Payers Expect (and We Make Easier)
Without slowing down clinic flow, we enable your team to record what payers seek.
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Medical necessity related to functional limitation, ineffective conservative treatment, and imaging results.
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Laterality and particular levels for spine-related operations.
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Technique details and image guidance (when separately billable).
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Results of SCS or pump trials, comprising functional alterations and pain levels.
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Start/stop timings for timed services and sedation when appropriate.
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UDS reasoning and outcomes are related to current treatment regimens.
We provide concise templates and quick checklists so the right details are always in the note.
How Our Technology Helps (Without Getting in Your Way)
We eliminate monotonous chores and stop errors using technology not to substitute for people.
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AI claim scrubbing flags missing modifiers, diagnosis specificity, level/laterality, and bundling conflicts before claims are sent out.
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Machine learning targets claims with a great chance of denails so that we can fix them proactively.
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Smart payment posting automates EOB/ERA data; flags underpayments against contract conditions.
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Live dashboards updated in near real time with denial trends, AR by payer, days in AR, net collection rate, and top CPT revenue.
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Simplified charge capture from your notes and operation logs to lower manual entry through EHR integrations.
You get cleaner claims, faster payments, and fewer distractions for your staff.
Workers’ Comp & Auto Injury (No-Fault/Liens)
These situations might overwhelm in-house departments. We handle:
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Medical record packet compilation and adjuster correspondence
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UCR navigation by state and fee schedule
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Appeal routes and timely filing calendars
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Clear mechanism of injury and medical need documentation
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Payment search that does not stop after the first follow-up
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