ModMed orthopedic workflow

AI-Assisted Surgical Scheduling for ModMed Ortho: From Decision-for-Surgery to Day-of-Surgery

The orthopedic surgical scheduling pipeline in ModMed has 23 distinct hand-off points between the decision-for-surgery encounter and the patient being wheeled into the OR. Every one of those hand-offs is a chance for a cancellation, a re-schedule, or a 30-day delay. AI sits across the entire pipeline, tracking each case, pushing each task to the right person, and calling the patient at every transition so your surgical coordinator can focus on the cases that actually need a human.

Ortho Surgical Pipeline · Built for ModMed

Pipeline Hand-Offs

Hand-off points between decision-for-surgery and day-of-surgery

Preventable Cancels

41%

Of surgical cancellations are preventable with proactive AI confirmation

Revenue Recovered

$4,800

Average revenue protected per recovered surgical case

Coordination Time

12d vs 34d

AI-assisted vs human-only pre-op coordination window

The five-stage workflow

The ModMed Ortho Surgical Scheduling Workflow, Stage by Stage

Every orthopedic case follows the same five-stage progression inside ModMed. The work the surgical coordinator does at each stage is different, the failure modes are different, and the right time to call the patient is different. AI plugs into all five stages and keeps the pipeline moving.

Stage 1: Decision-for-Surgery Encounter

• Surgeon documents the indication in the ModMed plan
• Surgery type, laterality, and CPT code captured
• Patient given printed pre-op instructions in the exam room
• Order set fired to surgery scheduling queue
• Patient often leaves overwhelmed and forgets half of it

Stage 2: Pre-Op Clearance Coordination

• PCP clearance ordered, cardiology if cardiac history
• EKG, CBC, BMP, type and screen, PT or INR as needed
• Pulmonology, hematology, or endocrine consult if flagged
• Results have to land in ModMed before clearance closes
• Most common stall point in the entire pipeline

Stage 3: OR Slot Booking

• Surgeon block time pulled from ModMed surgical scheduler
• Facility availability checked against block
• Implant or device rep coordination if joint or spine
• Anesthesia type confirmed, monitored vs general vs block
• Patient must reconfirm in writing before slot is locked

Stage 4: Pre-Op Call and Packet Delivery

• NPO instructions, medication hold list, arrival time
• Pre-op packet delivered by text or patient portal
• Anticoagulation hold protocol confirmed with PCP
• Driver and post-op support person confirmed
• Insurance pre-auth status verified one last time

Stage 5: Day-of-Surgery Prep

• Morning-before reminder call confirms NPO compliance, arrival time, and driver
• Patient flags any new symptoms, fever, or skin breakdown at the surgical site
• Last-mile escalation: if patient is not coming, the OR slot can still be back-filled
• AI logs the confirmation back to the ModMed case record so the OR board is accurate
• Surgical coordinator gets a clean exception list instead of 40 individual calls

AI at every stage

What the AI Does at Each Stage of the Pipeline

The AI is not a single call. It is a coordinator that wakes up at each transition, knows the case context from ModMed, and executes the right outreach. The surgical coordinator only sees the cases where the AI hit a real obstacle.

Within 48 Hours of the Decision-for-Surgery Encounter

AI calls the patient to confirm understanding of the proposed surgery, walks through the printed handout in plain language, answers common questions about recovery and time off work, and re-sends the pre-op packet by text. Catches the patient who left the office confused before they cool off and back out.

During Pre-Op Clearance Coordination

AI tracks insurance pre-authorization status by calling the payer line every 48 hours until the auth number lands, pings the PCP office for the clearance note, and calls the patient if they have not yet booked their cardiology consult. Status pushed back into the ModMed case so the coordinator does not have to chase.

At OR Slot Booking

AI checks ModMed surgical scheduler block availability, offers the patient two or three concrete dates, locks the slot once the patient picks, and triggers the implant or device-rep coordination workflow for joint and spine cases.

Pre-Op Packet Delivery, T-Minus 7 Days

AI delivers the pre-op packet by text and portal, reads the NPO and medication hold list out loud on the call, confirms anticoagulation hold dates with the patient and PCP, and verifies the driver and post-op support person.

Day-Before Reminder, T-Minus 1 Day

AI calls every scheduled surgical patient the day before, confirms NPO start time, arrival time, driver, and screens for any new symptoms that could cancel the case. Logs result back to ModMed and surfaces only the exceptions to the human team.

Ortho-specific surgical workflows

Tuned to the Four Major Ortho Case Types

A total knee is not a wrist scope. The AI runs a different script, a different timeline, and a different escalation matrix depending on the ortho case type pulled from the ModMed plan.

Joint Replacement (THA, TKA, TSA)

• Longest pre-op runway, often 6 to 12 weeks out
• Medical clearance and cardiac workup are common
• Implant size and vendor coordination at the facility
• Pre-op education class enrollment or video module
• Post-op SNF or home health setup before surgery date

Fracture ORIF

• Compressed timeline, often within 72 hours to 14 days
• Anticoagulation status check is urgent
• Hardware vendor must confirm tray availability fast
• Patient often anxious and in pain, needs warmer call
• Pre-op clearance abbreviated, surgeon decides what is needed

Arthroscopy (Knee, Shoulder, Hip)

• Short pre-op runway, 2 to 4 weeks typical
• Minimal medical clearance unless cardiac history
• Outpatient ASC, faster turnover, more cases per day
• Higher cancellation rate from upper respiratory illness
• Pre-op call focuses on NPO and post-op physical therapy setup

Spine Surgery (Lumbar, Cervical)

• Heaviest pre-auth burden, often 4 to 8 weeks of appeals
• Neuromonitoring and device-rep coordination required
• Cardiac and pulmonary clearance almost always
• Patient education on bracing, lifting limits, return to work
• Highest revenue per case, highest cost of cancellation

Hand-off rules

When AI Hands the Case to a Human Surgical Coordinator

The AI is not trying to replace the surgical coordinator. It is trying to free them from the routine 80 percent so they can handle the 20 percent that actually needs judgment. Explicit escalation triggers ensure nothing dangerous gets automated.

Cardiology Clearance Issues

Abnormal EKG, new arrhythmia on pre-op workup, cardiologist requests further testing, or clearance note flagged with conditions. AI does not negotiate cardiac risk. Coordinator gets paged with full context.

Complex Device-Rep Coordination

Custom implants, unusual sizes, revision cases, dual-vendor setups, or new device trials. AI confirms standard vendor presence but escalates anything non-routine to the coordinator.

Insurance Denials and Peer-to-Peer

If pre-auth comes back denied or requires a peer-to-peer review, AI immediately routes to the coordinator and surgeon. No automated appeal scripting on denials, the stakes are too high.

Patient Hesitation or Late Withdrawal

If the patient expresses doubt about proceeding, wants to talk to the surgeon again, or asks about cancellation on any AI call, the case is routed to a coordinator within the hour.

Full ModMed ortho coverage

The Complete ModMed Ortho AI Hub

Surgical scheduling is one of several workflows AI covers inside a ModMed orthopedic practice. The hub page covers intake, imaging coordination, PT referrals, and post-op follow-up.

See the ModMed Ortho Hub

See it on your calls

Hear the AI Run a Pre-Op Confirmation Call

In 20 minutes we will run a live pre-op confirmation, joint replacement scheduling call, and a clearance status check against your ModMed environment. You decide if it would replace the manual chase your coordinator does today.

Book a Live Demo

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