For Orthopedic Surgery
Prior Authorization Automation for Orthopedic Groups
EligibilityMD automates prior authorization for orthopedic surgery groups — so every surgical case is verified, documented, and approved before the patient is wheeled into the OR.
The problem
A single missed prior auth on a total knee or shoulder repair can mean the difference between a clean payment and a five-figure write-off you'll never recover. Your team is juggling payer portals, fax-back forms, and clinical documentation requirements that change quarterly — and the slip rate, however small, is destroying margin.
What EligibilityMD does
We monitor every scheduled surgical case from the moment it's booked, identify the payer's specific authorization requirements, package the clinical documentation, and confirm approval before the date of service. Exceptions are escalated to your clinical team with everything pre-attached.
What changes for your practice
- +Every surgical case verified and authorized before the date of service
- +Authorization status confirmed 5–7 days early on elective cases
- +Eligibility-based denial rate below 10% within 60 days
- +Surgical schedulers stop chasing payer faxes
Backed by our 90-day guarantee. If we don't hit the benchmarks we put in writing, you get your money back.
See also