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Musculoskeletal imaging

More MR referrals.
Fewer auth delays.

CIVIE helps MSK imaging keep up with orthopedic and sports-medicine referrals: prior authorization started when the order arrives, self-scheduling for patients, MSK templates in ASR and follow-up recommendations tracked to a booked exam.

Illustrative

The challenge

MSK volume rides
on the front desk.

  • MR authorizations that hold the schedule. Most MSK MR needs prior authorization, and a pending auth means a held slot or a patient pushed back.

  • Referrers who expect speed. Orthopedic and sports-medicine practices send their patients where booking is easy and reports come back fast.

  • Follow-ups that drift. Recommendations for repeat imaging sit in report text, and nobody owns getting the patient back.

The MSK front desk

Authorized and booked
before it slips.

Authorization, booking, referrer access and follow-ups on one record, so the MR schedule keeps up with the referrals.

Agent call · UnitedHealthcare

Written back
MR knee right w/o · 73721 · A. RuizRequested at intake · pending 2 days
  1. Called the payer's authorization line
  2. Status: approved · case number read back
  3. Case number written to the order
  4. Approval shown in Ana's booking link

Illustrative screens. Patient details are fictional.

One knee MR, start to finish

From the ortho office
to the claim.

One MSK order through CIVIE. Sample data throughout.

  1. Ordered from the portal.

    The orthopedic office orders online and sees scheduling, authorization and results in one place.

    Physician portal · Dr. Smith

    New order
    Marcus Bell · CT abdomen/pelvisReport signed · images availableFinal
    Ana Ruiz · MR kneeScheduled Thu 9:10 AMBooked
    Lee Park · CT sinusWaiting on prior authAuth
  2. Authorized and paid up front.

    Authorization is requested at order receipt, and the patient sees an estimate from your contracted rates.

    MR knee right w/o · estimate

    Paid at check-in
    Contracted rate · UHC PPO
    $459.77
    Remaining deductible
    $110.79
    Patient paid
    $110.79
    1. Authorization requested at order receipt
    2. Estimate from the contracted rate
    3. Payment posted to CIVIE RCM
  3. Coded from the report.

    AI-assisted coding reads the signed MSK report and suggests diagnoses for the coder to accept.

    AI coding · from the signed report

    Suggested

    “History: twisting injury 2 weeks ago. Impression: Small joint effusion. Medial meniscus posterior horn tear.”

    S83.241A · Medial meniscus tear96% · matches impressionAccept
    M25.461 · Effusion, right knee88% · matches findingsAccept
    CCI and LCD editsNo conflicts
  4. Every charge captured.

    Technical and professional charges come from the order and the signed report, and supplies come from the tech log.

    Charges from exam · MR knee right w/o

    Captured
    CodeDescriptionSource

    Any supplies the technologist logs are added as charges, so nothing billable is missed.

    Charges capturedFrom the order and the report

One ecosystem

The MSK practice
on one record.

Referral, authorization, schedule, images, report and claim live on the same record, so a delay at one step is visible at every other.

Connects to what you keep

  • Orthopedic and sports-medicine officesPhysician portal, fax, email or text, whichever they prefer.
  • Clearinghouses and payersEDI eligibility, claims, remittances and claim status.
  • Your EHROrders in and results out over HL7 and FHIR. The EHR stays the system of record.

FAQ

Questions,
answered.

  • When the order arrives. CIVIE checks payer rules, attaches clinicals from the order and tracks the request against the exam, and voice agents follow up on pending ones.

Next steps

Authorized, booked,
reported, followed up.

See an MSK order move through CIVIE, from the ortho office to the claim.