Why specialties

Start where the paperwork is hardest.

Orthopedics has the widest prior-auth surface area of any specialty. That makes it the sharpest wedge — and the same engine extends across specialty revenue cycle.

Widest surface area

Imaging, surgery, injections, PT, and DME each have their own approval process — more touchpoints than almost any other specialty.

Mostly winnable

Properly filed appeals overturn roughly half of denials, and 80%+ of appealed Medicare Advantage denials are overturned. The work is fixable paperwork.

3× the manual effort

Specialists spend roughly three times longer per manual prior auth than generalists. That's exactly the work Appelo prepares.

The orthopedic prior-auth surface

Six approval processes. One patient.

Advanced imaging

MRI, CT, and ultrasound each carry their own PA criteria and conservative-care prerequisites.

Surgery

Arthroscopy, joint replacement, fusion — high-value procedures with detailed medical-necessity review.

Injections

Viscosupplementation, epidurals, and joint blocks with frequency and step-therapy rules.

PT & rehab

Therapy courses authorized in visit blocks, re-authorized on progress documentation.

DME & orthotics

Braces, bone stimulators, and devices — each its own documentation and supplier path.

Re-authorizations

Ongoing care means recurring approvals, every one a fresh chance for a denial.

Then expand

The same engine, across specialty revenue cycle.

Cardiology, oncology, radiology, and GI run the same gauntlet — different criteria, same friction. Appelo's denial, gap-check, and prior-auth agents work wherever paperwork stands between care and payment.

OrthopedicsCardiologyOncologyRadiologyGastroenterology
Of appealed MA denials overturned80%+when properly filed

Yet most denials are never appealed. Appelo is built to close that gap.

See it on orthopedics first.

Then watch it work across the rest of your specialty mix.