Prior Authorization for Orthopedic Practices

At ConsultStar, we provide specialized prior authorization support for orthopedic practices. Orthopedic procedures— joint replacements, spine interventions, pain management, and advanced imaging frequently require detailed clinical documentation and payer-specific medical necessity criteria.

Our team handles the administrative process so your staff can focus on patient care. We work with the documentation already in your EHR, review submissions for completeness, and help reduce avoidable delays and denials.

Common Orthopedic Procedures We Support

• Total knee arthroplasty and revisions

• Total hip arthroplasty and revisions

• Shoulder arthroplasty and arthroscopy

• Spine procedures and injections

• Advanced imaging (MRI, CT) related to orthopedic conditions

How We Help

• Review clinical notes and imaging reports for payer criteria

• Prepare and submit authorization requests

• Track status and manage follow-up

• Support practices using AI documentation tools inside their EHR by refining drafts for accuracy and completeness

We support a range of commercial payers, Medicare Advantage plans, and other programs. Contact us to discuss your practice’s current prior authorization volume and workflow.