OrthoRelay
Built in Texas, for Texas Ortho Clinics

Prior Auth. Done Right. Built for Texas Orthopedics.

OrthoRelay is a Texas orthopedic prior auth workflow demo. It shows how a clinic could review case details, check payer requirements, and assemble a submission-ready packet using synthetic data before moving into a guided pilot.

Synthetic demo data · Texas ortho workflow · BCBS-TX & UHC examples · Guided pilot by request
View Product Demo → Request Walkthrough →
The public experience uses synthetic sample data. Admin workspace access is for guided demos and internal testing.
SyntheticPublic demo dataset
BCBS-TX + UHCCurrent payer focus
OrthoTexas orthopedic workflow
Guided pilotReal-data rollout by request

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 sample intake to packet review, the public demo shows the workflow we are validating with clinics.

1

Load sample case

Start from a synthetic orthopedic case with preloaded notes, payer context, and required fields.

2

Review extracted fields

Show how OrthoRelay organizes case details and highlights what staff should verify before submission.

3

Check requirements

Walk through payer-specific checklist logic and what documents are still needed before submission.

4

Packet preview & handoff

Generate a packet preview and handoff summary. Portal submission remains a guided workflow today.

Current payer focus

The public demo currently centers on BCBS-TX and UHC orthopedic scenarios. Additional payers are roadmap items, not production coverage today.

Blue Cross Blue Shield of Texas

Demo focus
Focused orthopedic walkthrough scenarios for the public demo
  • Knee MRI (73721)
  • Shoulder Arthroscopy (29827)
  • TKA (27447)
  • Lumbar Fusion (22633)
  • SI Joint Injection (27096)

UnitedHealthcare (Texas)

Demo focus
Focused orthopedic walkthrough scenarios for the public demo
  • Knee MRI (73721)
  • Shoulder Arthroscopy (29827)
  • TKA (27447)
  • Lumbar Fusion (22633)
  • SI Joint Injection (27096)

Texas Medicaid (STAR & STAR+PLUS)

Research backlog
Not part of the current public demo. Future expansion depends on workflow validation and payer-specific rule work.
  • UHC Community Plan
  • Molina Healthcare
  • Superior Health Plan (Centene)
  • Aetna Better Health TX
Gold Card exemption does not apply to Medicaid — every submission matters
Aetna TX (Commercial) Cigna TX Medicare Advantage
Rules shown in the public demo are curated examples for walkthroughs, not a production rules engine or live payer feed.

See it in action

From patient chart to packet review, shown as a guided demo workflow with synthetic data.

Roadmap concept

Texas Gold Card visibility is on the roadmap

We think clinics will want this view. The mockup below is illustrative and is not part of the current demo workspace.

Gold Card Status Dashboard
Concept mockup
Physician Payer Approval Rate Submissions Status
Dr. Sarah Mitchell BCBS-TX 94% 47 Illustrative ✓
Dr. James Ortega BCBS-TX 87% 31 Concept
Dr. Sarah Mitchell UHC 91% 38 Illustrative ✓
Dr. James Ortega UHC 76% 18 Building history
💡 Example concept: highlight physicians who may be close to a Gold Card threshold so staff can prioritize clean packets.
  • Planned rolling approval-rate visibility per physician and payer
  • Planned alerts when a physician may be approaching a Gold Card threshold
  • Planned exemption tracking once live payer data is in scope

Built for Texas Orthopedic Clinics

Built specifically for Texas orthopedic service lines (BCBS‑TX & UHC supported).

Orthopedic Surgery Sports Medicine Spine Surgery Pain Management

How we work with your clinic

Discovery first. Real-data pilots come only after security, workflow, and data-handling review.

1

Your team requests access

PA coordinator or office manager shares their workflow and pain points so we can tailor the walkthrough.

2

We set up your clinic

We scope workflow, access, and data handling before any live-data pilot is considered.

3

Your team starts saving hours

If there is a fit, we plan a guided pilot with explicit scope, data rules, and success metrics.

What clinics want to improve

The demo is built around three outcomes teams care about. Exact impact still needs to be measured in a real pilot.

Less rework
Fewer missing items before submission
Faster prep
Shorter staff prep cycles
Clear queue visibility
One place to see case readiness
Synthetic public demo BCBS-TX & UHC examples Admin workspace by invite Pilot scoping available Texas ortho focus

Request a guided walkthrough

Tell us about your clinic and workflow. We will use it to tailor the next demo or pilot discussion.

Email [email protected] Email [email protected] Open request page →
Include clinic name, specialty, payer mix, and whether you want a walkthrough or pilot discussion. Do not send PHI.