OasisLMS

The administrative burden on orthopedic practices has reached a breaking point in 2026, driven by major CPT code updates, new federal mandates for prior authorization turnarounds, and relentless payer scrutiny. For lean-operating practices, these headwinds represent more than routine compliance challenges—they directly jeopardize revenue stability and extend accounts receivable timelines.

During this presentation, Athelas will examine key shifts in the 2026 orthopedic reimbursement landscape and identify where practices face the greatest risk of payment delays and claim denials. The discussion will highlight how top-performing medical groups leverage AI-driven automation to transform these industry hurdles into a strategic advantage, consistently achieving first-pass clean claim rates above 95%. Participants will gain an actionable framework to evaluate their revenue cycle operations under current 2026 regulations, alongside a clear plan for targeted automation that yields high ROI.

• Recognize the leading causes of orthopedic claim denials in 2026 (documentation specificity, site-of-service payment shifts, payer algorithm scrutiny) and where they most commonly originate in the revenue cycle.
• Assess how AI and automation can effectively decrease administrative work and denial rates, while pinpointing key areas where human expertise must remain central.
• Build a practical checklist for auditing their own practice's revenue cycle against 2026's regulatory and payer landscape.

Ashley earned her Master of Occupational Therapy degree from the University of Florida in 2015 and built her clinical career with a focus on hand therapy and upper extremity orthopedics. She later obtained her Certified Hand Therapist (CHT) designation and spent several years working in clinics across Florida, North Carolina, and Hawaii.