ROM Nexus scores every orthopedic case for medical necessity in under 90 seconds — building bullet-proof authorization packets, flagging denial risk, and protecting revenue before the payor ever sees it.
No credit card · HIPAA-secure · Results in 7 days
Trusted by 200+ orthopedic practices, ASCs & physician-led MSOs
$840M+
Revenue Protected
94.2%
First-Pass Approval
-38%
Denial Rate
14 hrs
Saved Per Case
The Hidden Tax on Every Ortho Practice
Yet your team spends more time chasing prior auths than treating patients — and the math is getting worse every quarter.
1 in 4
Every denial burns 14+ staff hours, delays the patient's surgery, and risks losing the case to a competitor.
$480K
Avoidable denials, downcoding, and under-documented medical necessity quietly drain six figures from your bottom line.
23 days
Your patients are in pain. Your OR block is shrinking. And your competitors are using AI to close in days, not weeks.
Introducing ROM Nexus™
Range of Motion. Revenue Optimization. Medical Necessity. One intelligence hub that qualifies every case, builds the auth packet, and guards your margins from intake to ERA.
01
Scores every TKA, lumbar fusion, RTC and ACL case against payor-specific medical necessity criteria in under 90 seconds.
02
Auto-builds the clinical narrative, PROMs, imaging interpretation, and conservative-care timeline payors actually approve.
03
Real-time risk meter flags missing PROMs, weak narratives, and coding mismatches before submission — not after.
04
Pre-billing QA, CPT/ICD validation, and audit-defense logs keep every dollar you earned in your bank.
How It Works
Plug ROM Nexus into your EHR (Epic, Athena, Modernizing Medicine, eCW) with zero IT lift. HIPAA + SOC2 signed before kickoff.
Our orthopedic-trained AI reviews each chart, scores medical necessity, and assembles the prior auth packet your payor mix expects.
Fewer denials. Faster ORs. Cleaner audits. A revenue integrity dashboard your CFO will actually open.
Case Study
Before ROM Nexus, the team was burning 22 staff hours per denied case and losing 1 in 4 TKA authorizations on first submission. 90 days after go-live, their CFO walked into the boardroom with this:
Get the same audit for free+38%
Approval rate lift
-71%
Denial volume
14 hrs
Saved per case
$1.42M
Revenue protected / 90d
“We used to lose entire ORs to missing PROMs. ROM Nexus flags it before submission — our first-pass approval went from 71% to 94% in one quarter.”
Dr. Sarah Henderson, MD
Managing Partner, Pacific Orthopedic Group
“It's the only tool I've seen built by people who actually understand ortho UM. The denial risk score alone is worth the price of admission.”
Marcus Alvarez
VP Revenue Cycle, Cornerstone MSO
“My UR nurses got their evenings back. That's the real ROI nobody puts in the deck.”
Dr. James Park, MD
Spine Surgeon · 12-Provider Practice
| Capability | ROM Nexus | Legacy PA Tools |
|---|---|---|
| Built only for orthopedics | ✓ | ✕ |
| Medical Necessity Score per case | ✓ | ✕ |
| Auto-generated auth packets | ✓ | ✕ |
| Denial Risk meter pre-submission | ✓ | ✕ |
| Payor-specific rule engine | ✓ | ✕ |
| Revenue Integrity QA | ✓ | ✕ |
| 14-day go-live | ✓ | ✕ |
| HIPAA + SOC2 | ✓ | ✓ |
Most practices are live in 14 days. Our team handles the EHR integration, payor rule mapping, and staff training so your front office never skips a beat.
Yes — HIPAA, SOC 2 Type II, and HL7-native. Every PHI interaction is logged, encrypted at rest, and auditable.
Epic, Athena, Modernizing Medicine, eClinicalWorks, NextGen, and any FHIR-compatible system. We also support flat-file CCDA import for smaller practices.
Pricing is per-surgeon per-month with no implementation fee. Most groups recoup their annual investment within the first 60 days through denial reduction alone.
Yes. ROM Nexus Enablement Services is our physician-led MSO — we'll run your utilization review, prior auths, and revenue integrity on the platform for you.
Limited cohorts — Q3 2026
We'll analyze your last 90 days of orthopedic denials and show you exactly how much revenue ROM Nexus would have protected — in a 30-minute call.
HIPAA-secure · No credit card · 30-min Zoom · Results emailed in 7 days