Prior Auth. Done Right. Built for Texas Orthopedics.
Texas orthopedic clinics lose thousands of hours a year to prior authorization — rotator cuff repairs, ACL reconstructions, lumbar fusions, total knee and hip replacements. OrthoRelay reads your clinical notes, checks your BCBS-TX and UHC requirements, and builds compliant submission packets in minutes. Less denial. More patients served.
Why prior auth drains your team
Auths vary by payer and plan. Staff re‑key EMR data, chase checklists, and fight denials from missing elements.
Time sink
30–90 minutes per auth across faxes, portals, and phone trees.
Preventable denials
Missing notes, LoMN, or imaging evidence lead to rework and cancellations.
Inconsistent packets
Every payer/plan is different. Results vary by staffer and day.
How OrthoRelay works
From intake to packet — standardized and compliant, ready to submit.
Upload docs
Upload clinic notes, imaging, and op reports for rotator cuff, ACL, spine, and total joint cases.
AI extracts & checks rules
Extracts CPT/ICD (e.g., 29827, 27447, 22633) and maps BCBS‑TX/UHC ortho policies into a point‑by‑point checklist.
Builds compliant packet
Auto‑fills payer forms and assembles packets with conservative therapy, imaging, LoMN, and surgical indications.
Track & submit
Submit to BCBS‑TX and UHC portals; track approvals for knee, shoulder, and spine — live status coming next.
Built for Texas Payers
We've mapped BCBS-TX and UHC commercial prior auth rules for orthopedic procedures — and we're building Texas Medicaid STAR coverage next. Because your PA burden doesn't stop at commercial insurance.
Blue Cross Blue Shield of Texas
Live Coverage- Knee MRI (73721)
- Shoulder Arthroscopy (29827)
- TKA (27447)
- Lumbar Fusion (22633)
- SI Joint Injection (27096)
UnitedHealthcare (Texas)
Live Coverage- Knee MRI (73721)
- Shoulder Arthroscopy (29827)
- TKA (27447)
- Lumbar Fusion (22633)
- SI Joint Injection (27096)
Texas Medicaid (STAR & STAR+PLUS)
Coming Q3 2026- UHC Community Plan
- Molina Healthcare
- Superior Health Plan (Centene)
- Aetna Better Health TX
See it in action
From patient chart to compliant packet in minutes — not hours.
Track Your Path to Texas Gold Card Status
Texas law requires payers to waive prior auth for physicians with a 90%+ approval rate. Most clinics don't know where they stand. We show you — physician by physician, payer by payer.
| Physician | Payer | Approval Rate | Submissions | Status |
|---|---|---|---|---|
| Dr. Sarah Mitchell | BCBS-TX | 94% | 47 | Gold Card Active ✓ |
| Dr. James Ortega | BCBS-TX | 87% | 31 | 3% to qualify |
| Dr. Sarah Mitchell | UHC | 91% | 38 | Gold Card Active ✓ |
| Dr. James Ortega | UHC | 76% | 18 | Building history |
- Automatic 6-month rolling approval rate calculation per physician per payer
- Alerts when a physician is within 5% of Gold Card threshold
- Exemption tracking — know when your Gold Cards expire before the payer tells you
Built for Texas Orthopedic Clinics
Built specifically for Texas orthopedic service lines (BCBS‑TX & UHC supported).
How we work with your clinic
No shadow IT. Proper compliance from day one.
Your team requests access
PA coordinator or office manager fills out the form to start your pilot.
We set up your clinic
BAA signed, accounts created, payer rules configured, staff onboarded.
Your team starts saving hours
Upload docs, get compliant packets, reduce denials — track status end‑to‑end.
ROI you can measure in weeks
Early pilots show faster prep, fewer reschedules, and clearer ETAs for schedulers and surgeons.
Request Access for Your Clinic
We'll reach out within 24 hours to set up your clinic's pilot.