PAIN MANAGEMENT · TEXAS
Prior-auth denials and CO-97 bundling are costing your practice more than you track
Pain management practices in Texas face some of the highest denial rates in outpatient care. Nerve blocks, injections, and non-opioid alternatives are systematically underpaid. Ivera detects every denial from your remittance files, appeals autonomously, and adds 18% statutory interest on the payer's delay.
What we recover
The denial patterns that drain pain management revenue
Each pattern below has a documented appeal pathway. Ivera executes all of them, automatically, from your existing remittance data.
Bundled procedure denials
Payers bundle nerve block and injection CPT codes as "included" in a higher-level service, denying payment that the clinical record fully supports. Ivera drafts an unbundling rebuttal from the procedure notes.
Prior-auth rejections
Nerve blocks, epidural steroid injections, and spinal cord stimulation trials are high prior-auth targets. Ivera identifies auth-denial patterns and appeals with the clinical pathway documentation.
Documentation requests
Payers request operative notes, functional assessments, and conservative-treatment history before paying. Ivera surfaces the exact document needed and routes it to your team's action queue.
Non-opioid treatment disputes
Ketamine infusions, regenerative medicine, and non-opioid pain protocols are routinely denied as experimental. Ivera appeals with published clinical evidence and Texas payer-specific policy language.
How Ivera works for pain practices
Autonomous recovery, start to finish
Ivera reads your 835 remittance files, identifies every recoverable denial, drafts a specialty-specific appeal, and submits it directly to the payer portal. Your billers never touch it.
- Autonomic detection from your 835 remittance files
- Appeals drafted with procedure-specific clinical evidence
- Direct submission to Availity and payer portals
- 18% Texas statutory interest billed on every delayed payment
- No EHR password required
- Contingency-based: you only pay when we recover
Claim 07P-1148
BlueCross BlueShield TX · CPT 64483
Denial detected
835 · CO-97 · $487.00
Appeal drafted
Nerve block unbundling rebuttal · 3s
Submitted to payer
Availity portal · auto-filed
Recovered $487.00
plus $87.66 Texas statutory interest
Denial reason: CO-97 Bundled procedure, nerve block (CPT 64483) with office visit overturned on first appeal
Illustrative results
A Texas pain management practice, 90-day audit
In a forensic audit of 90 days of remittance data from a Texas pain practice, Ivera identified recoverable denied revenue across prior-auth rejections, CO-97 bundling disputes, and documentation-request writeoffs. These are illustrative figures consistent with what we find in similar audits.
Results vary by practice, payer mix, and denial volume. We share the actual numbers from your data in your free denial review.
$38,400
Recoverable denied revenue
$6,912
18% statutory interest owed
87%
Appeal overturn rate
Free denial review for pain practices
Find out exactly what your payers owe you
Upload 90 days of remittance data. Ivera runs a forensic audit and shows you every recoverable prior-auth denial, CO-97 dispute, and documentation writeoff, plus the 18% Texas statutory interest your payers owe for every late payment. No EHR password. No commitment.
Get Your Free Denial Review