Columbia Pain Management
How Columbia Pain surfaced 9.2% in code-level revenue gaps across their top payers.
A Pacific Northwest interventional pain group ran their procedural codes through Aroris and discovered systematic under-payment hiding in modifier rules and place-of-service handling.
Sample case detail for layout review. Final figures and copy pending client approval.
- Practice
- Columbia Pain Management
- Specialty
- Pain management, interventional
- Providers
- 14 physicians, 6 nurse practitioners
- Location
- Oregon and SW Washington
- Services used
- Optimization, Negotiation, Live Claims Monitoring
- Engagement length
- 14 months
The situation
Columbia Pain had been told for years their reimbursement was “standard for the market.” A CFO transition triggered a fresh look, and the new finance leader insisted on outside data, not anecdote. The team needed code-level evidence before opening rate conversations with their commercial payers.
What Aroris did
Aroris layered Columbia’s claims history against our procedural-code dataset, isolating modifier patterns and place-of-service handling that were silently suppressing payment on three of their top eight CPTs. We built a single-page rate brief per payer with the math behind every ask.
- Mapped 18 months of claims data against the Aroris benchmark dataset.
- Identified three procedural codes consistently under-paid across two commercial payers.
- Authored payer-specific rate briefs ready for negotiation in week one.
- Live Claims Monitoring flagged $58K in re-bill opportunity in the first month alone.
The outcome
Columbia signed +9.2% weighted across procedural codes within four months. Ongoing monitoring has recovered an additional $640K through caught discrepancies the prior workflow missed. The CFO now reports payer performance to the board with hard numbers, monthly.
“The depth of their code-level analysis surfaced revenue we genuinely didn’t know we were leaving on the table.”David Russo
Partner, Columbia Pain Management
About Columbia Pain Management
Columbia Pain Management is an interventional pain practice with five clinics across Oregon and southwest Washington, serving the region since 1996.
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