Operations
A pain consultation held without the referral or the outside imaging usually turns into a second appointment. This page covers capturing the referring provider, the referral requirement, and existing MRI or CT studies during the intake call.
The referring provider is asked for on the call. If the wrong provider is on file, your staff correct it ahead of the visit rather than discovering it while an authorization request sits unanswered.
An MRI from a few months ago or X-rays from the primary care office get recorded during intake. Your team can request the existing study instead of sending the patient for a repeat.
Knowing which facility holds the films, and which outside notes are needed, gives your staff the lead time to request them before the consultation rather than after it.
For plans that require documented prior therapy, what the patient has already tried is captured during the call, so your team is not reconstructing the history from memory at submission time.
Insurance captured on every call
Carrier, group number, and member ID documented during initial intake
Referral status confirmed
Referral physician and authorization status verified before the appointment
Structured summary for billing
Your billing team receives complete insurance and referral details, ready to submit authorization
Prior imaging documented
Existing MRI, CT, or X-rays logged so unnecessary duplicates are avoided
The referring provider's name, practice, and fax number are captured on the call, or the patient supplies them. Your staff use that to verify the referral and request it formally. The call collects the data; the referral workflow stays with your team.
The patient is asked what studies they have had, approximately when, and where. Those answers go into the summary so your staff can request the films or reports from the facility rather than ordering a duplicate.
Whatever the patient can give is recorded, and the summary marks the referral as needing verification. Your staff can follow up with the patient or check the source of the referral in your own records.
Yes, when you have configured that rule. For example, a note that a particular carrier requires documented conservative treatment first appears as a flag in the summary so your billing team knows what evidence to gather.
It is returned in a structured, EMR-pasteable summary for your staff to review and enter. Keeping entry with your team is deliberate, because referral and insurance records are the ones an error is most expensive in.
Workflow
Patient intake
Structured intake captures insurance, referral, and prior history in one call
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Next step
AI receptionist for pain management practices
How call handling differs for pain management practices.
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