Orthopedics

Orthopedic claim denials, appealed.

Orthopedic practices carry some of the highest-dollar denials in specialty care: imaging, injections, durable medical equipment, and surgical procedures that payers deny for medical necessity, prior authorization, or bundling. The large ones cost staff hours to fight; the smaller ones get written off. Canopy prepares both.

Common orthopedics denials we help appeal

  • Advanced imaging (MRI or CT) denied for medical necessity or missing prior authorization.
  • Joint injections and viscosupplementation denied on frequency or medical-necessity grounds.
  • Durable medical equipment (braces, supports) denials.
  • Surgical procedure denials and bundling or global-period disputes.
  • Physical therapy and post-op care denied as exceeding limits.
  • Modifier denials on staged or bilateral procedures.

54% of denied claims are overturned when practices appeal them.

Source: Premier, 2024.

65% of denied claims are never reworked or appealed.

Source: MGMA.

A single appeal can cost $64 to $118 in staff time, which is why small claims get abandoned.

Source: industry / Premier.

You stay in control. We prepare the appeal.

Upload the payer’s denial or underpayment. Canopy analyzes it and prepares a complete, ready to file appeal package. You file it with the payer under your own letterhead, the payer pays you directly, and Canopy charges a flat success fee only on what you actually recover.

See the full how it works →

See what your orthopedics write-offs are worth.

Use the calculator to estimate the revenue you’re leaving on the table, then apply to get started.