Pain Management

From referral to procedure,
without the bottleneck.

Pain management practices process complex referrals requiring multi-step prior authorization for interventional procedures. TriFetch automates every step from intake to confirmed procedure date.

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01 Referral Intake

Every referral classified the moment it arrives.

Interventional procedure referrals are separated from consultations and follow-ups at intake and immediately routed to authorization. Incomplete referrals missing required imaging are returned to the referring provider before any staff member touches the file.

Procedure type classification

Interventional referrals such as epidurals, nerve blocks, and spinal cord stimulator trials are separated from consultations at intake and immediately queued for prior authorization.

Incomplete referrals handled

Referrals missing required imaging, prior treatment documentation, or clinical notes trigger an automatic fax-back to the referring provider specifying exactly what is needed.

Inbound Referral Queue Auto-classified
InterventionalLumbar epidural, nerve block
ConsultationComplex chronic pain, new patient
Follow-upPost-procedure assessment
Missing docsPrior imaging required, fax-back sent
Interventional cases routed to authorization immediately
Prior Authorization Tracker Same-day submission
Aetna
Lumbar epidural (CPT 62323)
Approved
UnitedHealth
Nerve block (CPT 64483)
Submitted
Cigna
SCS trial (CPT 63650)
Pending clearance
Denial docs staged automatically
02 Prior Authorization

Submitted same-day. Tracked automatically.

Interventional procedures require multi-step authorization that varies by payer, procedure code, and clinical criteria. TriFetch identifies the requirement, populates the request from the referral, and submits same-day without staff involvement.

Procedure-specific submission

Authorization requirements identified by payer and CPT code at intake. Requests populated and submitted same-day for epidurals, nerve blocks, spinal cord stimulator trials, and kyphoplasty procedures.

Denial management

Denied authorizations are flagged with supporting documentation staged for appeal. Staff do not need to rebuild the case from scratch.

03 Eligibility

Every patient verified before a slot is offered.

Interventional procedure coverage varies significantly by payer and plan. TriFetch verifies eligibility, deductible status, and procedure-specific coverage automatically before any appointment is offered.

Procedure-level coverage check

Eligibility verified at the procedure level for each accepted referral. Payer-specific limitations and network requirements enforced before any slot is offered.

Ineligible cases filtered early

Referrals with coverage gaps or out-of-network status excluded before entering the scheduling queue, preventing billing issues downstream.

Eligibility Verification
✓ Primary insurance verified
✓ Interventional procedure coverage
✓ Network status confirmed
✓ Deductible status checked
✓ Pre-auth requirement flagged
All checks run automatically · No manual lookup
AI Phone Agent · Procedure scheduling Live
LindaHi, calling from Pacific Pain Management. Your authorization for the lumbar epidural has been approved. I'm reaching out to schedule your procedure.
Great, I was waiting to hear back.
I have availability on Friday at 9 AM. You will need a driver and should not eat after midnight. Does Friday work?
Yes, Friday works. I can arrange a driver.
Confirmed. Pre-procedure instructions will be sent to you by text shortly.
04 Patient Scheduling

Booked and confirmed. No coordinator required.

After authorization is confirmed, the agent contacts the patient, schedules the procedure, collects driver confirmation, and sends procedure-specific prep instructions, all in one call.

AI phone outreach

Agent calls after auth confirmation, schedules the procedure, collects NPO and driver requirements, and sends pre-procedure instructions specific to the intervention type. All interactions logged to the EHR.

Auth-gated scheduling

No patient contacts are initiated until authorization is confirmed. Scheduling only begins once all clinical and insurance prerequisites are met.

05 EHR Integration

Charts built. Documents filed. Ready for approval.

Patient charts created from referral intake data with imaging records, authorization documents, and medication history reconciled automatically. Staff approve at a single checkpoint before finalization.

Automated chart creation

Patient demographics, imaging records, prior treatment notes, authorization documents, and medication history uploaded and categorized automatically. All required fields populated from the referral.

Human in loop

Staff approve each chart before it is finalized. Oversight without data entry.

Chart Build · Auto-populated
✓ Patient demographics
✓ Referring provider linked
✓ Imaging records uploaded
✓ Authorization record filed
✓ Medication history reconciled
Awaiting staff approval
Ready to get started?

See how TriFetch works for your pain management practice.

Book a Demo → Call Linda · (240) 981-5499