MyOrthoHealth – Hip & Knee Surgery FAQs

MyOrthoHealth - Hip & Knee Surgery is an innovative program that coordinates and “bundles” all the services needed to help orthopaedic surgery patients experience a successful procedure and recovery. 

Orthopaedic procedure bundles offered at this time include:

• Total knee replacement
• Total hip replacement

This program provides patients with a high-touch care experience through an assigned Vanderbilt Health patient navigator, facilitated access to Vanderbilt Health providers, and an enhanced focus on convenience and communication with predictable out-of-pocket costs.

Please visit your employer’s benefits website to confirm, or contact one of our patient navigators through the Chat box below.

Please check with your employer to confirm eligibility for the bundle, or contact one of our patient navigators through the Chat box below.

Eligible employees must enroll with a patient navigator prior to the surgery. Start a conversation with a patient navigator in the Chat box below or schedule an appointment at this link.

You must be enrolled in a bundle-eligible health plan. You can move between bundle-eligible health plans mid-bundle, but you cannot transition to an ineligible health plan and stay in the bundle. If you make any changes to your health plan, please contact your patient navigator. Please visit your employer’s benefits website to confirm which health plans qualify, or contact one of our patient navigators through the Chat box below.

The program provides coordinated orthopaedic surgery care beginning on the day of enrollment by an eligible member and ending 90 days after the joint replacement procedure. 

Services include:

• Concierge service with a dedicated patient navigator
• Services delivered by Vanderbilt University Medical Center during the bundle related to your joint replacement procedure, including labs, imaging and clearances as needed
• Convenient telehealth services for qualified patients for appointments after surgery
• In-person physical and occupational therapy
• Pre-surgery education
• Necessary durable medical equipment (DME) as clinically indicated by the provider, such as rolling walker or shower chair

• Services provided outside of the program window
• Non-joint related care
• Physical and occupational therapy
• Outpatient prescription drugs
• Services provided at locations not included in the bundle

The Vanderbilt Orthopaedics patient education and virtual rehab platform is available to all MyOrthoHealth - Hip & Knee Surgery patients, and provides virtual patient care and education. This care platform releases education and pre-surgery exercise instruction, as well as guided physical and occupational therapy and communications tailored for you, directly from your care team. Don’t worry: Your care team will make sure you’re up and running with the platform and will answer any questions you have.

Your nurse will be in touch to explain the DME and prescriptions you will need and where to receive those items. The nurse will also answer any questions you may have to help prepare you for surgery. Please consult with your nurse about getting your DME prior to surgery to get comfortable with the items and learn how they can help in your recovery.

Coverage begins on the day of enrollment by an eligible Member and ends 90 days after the joint replacement procedure.

Any hip or knee appointments and/or services that occur after the bundle ends will be billed to your traditional health insurance.

For a current list of locations participating in the bundle program, view this link for a searchable map. The map may take a moment to load depending on your internet connection.

While replacement surgery is an effective treatment for the right patient, it’s not the right solution for everyone. The best way to determine if surgery is right for you is through an in-person consultation with one of our orthopedic surgeons. Together, we will determine the best course of care for your unique health needs.

If you don’t clinically qualify for surgery and the MyOrthoHealth – Hip & Knee Surgery Bundle, Vanderbilt Orthopaedic clinics offer a full spectrum of services to address your condition, including physical therapy, medications and injections.

Patients and their caregivers should consider their FMLA and short-term disability paperwork early in the process.

Both the patient and their caregiver should be prepared to reach out to their respective employers and complete FMLA and/or short-term disability paperwork immediately following the surgical consult. The timeline for processing this paperwork may vary depending on employer, so it is best to complete this as soon as possible to prevent any delays to the scheduled surgery date.

If you would like to enroll in the Total Joint bundle for the replacement of multiple joints, you must complete the Total Joint bundle for one joint, then re-enroll in the Total Joint bundle for replacement of a subsequent joint.

The bundle does not cover revision surgeries.

Start a conversation in the Chat box below to check your eligibility. If you are eligible or have additional questions, schedule an appointment at this link.