Orthopedic practices are entering 2026 with one of the highest administrative loads the specialty has ever seen. Prior authorizations require more documentation. Payers have introduced more steps. Portal work has multiplied. Denials are more technical. And staffing pipelines have thinned to the point where hiring more people simply isn’t a reliable strategy anymore.
Amid this reality, the practices that are staying ahead share one trait: they’re automating the workflows that no longer make sense for humans to perform.
Not because humans aren’t capable — but because the work itself is repetitive, rules-based, error-sensitive, and often requires hours of portal clicking, document hunting, and follow-up. That’s exactly the kind of work orthopedics can no longer afford to manage with scarce staff time.
Below are the seven workflows every orthopedic group should automate in 2026, why each matters, and how high-performing practices are operationalizing them.
1. Prior Authorization Intake & Documentation Prep
If there is a single workflow that eats up more staff time than any other in orthopedics, it’s gathering documentation for prior auth. A single surgery or injection can require pages of clinical details pulled from different parts of the EHR, PACS, PT systems, physician notes, and payer criteria.
Most practices underestimate how much time this consumes. Staff must search, download, reformat, and attach clinical documents for each case — and even small omissions cause denials that may take weeks to unwind. When volumes rise, document-gathering alone can swallow entire days.
This workflow is a perfect fit for automation. Modern AI systems can retrieve required notes, assemble complete documentation packets, verify that clinical criteria are met, and prepare submissions consistently. This ensures every case begins with a complete file — something that’s incredibly difficult to maintain manually when teams are stretched thin.
Magical’s AI employees for prior authorizations automatically pull the exact packets needed for each payer before submitting the authorization request.
2. Payer Portal Submissions
Portal submission work has expanded dramatically. What used to be a few-step process now requires navigating multiple companies’ systems — Availity, NaviNet, EviCore, AIM/Carelon, and dozens of proprietary payer portals.
These portals change regularly, vary across products, and demand tedious, repetitive data entry. Staff often complete the same actions dozens of times a day: log in, search for a patient, fill in demographic fields, attach documents, and click a sequence of predictable steps.
This isn’t high-value work. It’s mechanical, structured, and highly automatable.
Automation can handle the entire submission sequence, freeing staff from hours of portal-driven clicking. And because AI employees execute the steps the same way every time, errors and omissions drop significantly — speeding approvals and reducing rework.
3. Prior Auth Status Checks & Follow-Up
Status checking is one of the most deceptively time-consuming tasks in an orthopedic practice. Everyone knows it matters — but no one has the bandwidth to do it as frequently as the workflow demands.
Most practices check portal statuses once or twice a week because it’s all they can manage. But payers update determinations unpredictably. Missing an approval can delay surgeries unnecessarily. Missing a denial can delay corrections until it’s too late. Missing a partial approval can mean entering the OR with uncovered CPTs.
Automating this workflow eliminates that risk. AI employees can check every portal, every pending request, at whatever frequency the practice needs — hourly, nightly, or continuously. Updates get logged automatically. Denials get surfaced immediately. And no case ever goes unnoticed because a staff member was in back-to-back calls or covering another role.
This is one of the most common automations run on Magical — reducing delays, preventing cancellations, and stabilizing surgical schedules.
4. Eligibility & Benefits Verification
Eligibility seems simple — until it isn’t. Orthopedic groups deal with high-dollar imaging, PT caps, surgical copays, and secondary coverage that often gets missed. Many denials that appear “complex” can be traced back to small eligibility oversights that snowball downstream.
The work itself involves all the characteristics of an automation-friendly workflow: structured data retrieval, checklist-driven steps, and a predictable set of payer-specific details that must be captured consistently.
Automating eligibility ensures more complete capture of MSK-specific benefits, more reliable insurance verification, and fewer downstream claim errors. It also creates cleaner handoffs between scheduling, authorization, and billing — something that’s increasingly valuable in 2026 as staffing gaps widen.
5. Coding Prep & Documentation Collection
Orthopedic coding requires expertise — but much of what coders spend time on isn’t expertise-driven. It’s preparation.
Before they assign a single CPT code, coders often need to gather:
operative reports
imaging and radiology documentation
clinic notes describing conservative therapy
PT summaries
documentation from outside referrals
This “prep work” can take just as long as the coding itself, especially for complex surgical cases. And it’s tedious work that varies little from case to case.
Automating the collection and organization of pre-coding materials allows coders to start each case with the full clinical picture already gathered and neatly sorted. This improves accuracy, reduces cycle time, and protects skilled coding staff from burnout.
6. Denials Triage & Categorization
Every orthopedic practice struggles with denials — but the real bottleneck isn’t appeals. It’s the triage. Sorting through remits, deciphering denial codes, and routing claims to the correct team members can take hours every week.
Automation can categorize denials by type, identify patterns, and send them directly to the right queue. That means billers and appeals staff spend their time resolving issues — not trying to understand what the issue even is.
Reducing the triage burden also prevents backlogs, which are costly. When denials age past certain thresholds, recoverability drops dramatically. Automating the front end of the denials workflow prevents this from happening and ensures faster action.
Magical frequently automates this process so humans can focus on resolution, not sorting.
7. Payment Posting Prep & Reconciliation Work
Payment posting is central to understanding a practice’s financial health — but it’s also one of the most repetitive workflows in the revenue cycle. Much of the posting process involves organizing remits, matching them to expected payments, preparing posting files, and flagging discrepancies.
Human billers still review and complete the final posting. But automation can handle the heavy lift: organizing the data, matching values, and presenting exceptions for review. This removes hours of manual work and speeds up the process significantly.
Faster posting leads to earlier denial discovery, quicker secondary claims, and more accurate financial reporting — all essential in an environment where orthopedics faces more variability than ever before.
Why Automating These Workflows Is No Longer Optional
There was a time when automation was a competitive advantage. In 2026, it’s moving closer to a requirement.
Orthopedic practices need automation because the external forces shaping their work have changed:
Staffing shortages are structural, not temporary.
Payer complexity is increasing, not stabilizing.
Revenue cycles are more variable, not predictable.
Portal workloads are multiplying, not shrinking.
Practices that rely solely on human labor face increasing difficulty keeping up — not because their people aren’t capable, but because the work itself is no longer compatible with scarce staff capacity.
Automation creates stability. It creates consistency. It creates predictability. And it protects teams from burnout by absorbing the most mechanical and draining parts of the workflow.
Magical’s agentic AI employees are built specifically for these kinds of workflows — taking on repetitive, rules-driven sequences so human teams can focus on clinical care, exceptions, and revenue protection.
How Leading Ortho Groups Are Rolling Out Automation
The most successful orthopedic groups do not try to automate everything at once. They pick one or two high-volume workflows — typically prior auth or eligibility — and build from there.
Their rollout patterns are similar:
Start with a single, well-defined workflow
Demonstrate measurable time savings and error reduction
Reinvest the freed capacity into higher-value work
Expand automation into adjacent workflows
Gradually shift staff toward oversight and exception management
It’s not a dramatic overhaul. It’s a steady replacement of manual effort with consistent, automated execution.