MyOrthoHealth – Hip & Knee Surgery FAQs
What is the Hip & Knee Surgery Bundle?
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
How will this new program benefit orthopaedic surgery patients?
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.
What does the Hip & Knee Surgery Bundle cost?
Please visit your employer’s benefits website to confirm, or contact one of our patient navigators through the Chat box below.
Who is eligible?
Please check with your employer to confirm eligibility for the bundle, or contact one of our patient navigators through the Chat box below.
How do I enroll in the bundle?
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.
What happens if my health plan changes mid-bundle?
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.
What services are included in the bundle?
The program is designed to provide coordinated orthopaedic surgery care from the initial surgical consult through 90 days after surgery.
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 therapy
- Pre-surgery education
- Durable medical equipment (DME), including:
Knee replacement:
- Rolling walker
- Shower chair or tub bench
Hip replacement:
- Rolling walker
- Elevated commode seat
- Grabber
- Sock assist
- Long handle shower scrub
- Leg assist
- Shower chair or tub bench
What services are NOT covered by the bundle?
- Services provided outside of the program window
- Non-joint related care
- Occupational therapy
- Outpatient prescription drugs
- Services provided at locations not included in the bundle
What is the Vanderbilt Orthopaedics patient education and virtual rehab platform?
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 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.
When should I get my durable medical equipment (DME), and how can I support my surgery success?
Your nurse will be in touch to explain the DME and prescriptions you will need and where to receive those items, and 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.
How long does the Hip & Knee Surgery Bundle last?
Bundle coverage begins upon bundle enrollment and from the initial patient consultation with an eligible VUMC surgeon. It ends 12 weeks after the joint replacement procedure.
What happens if I still have hip or knee appointments after my bundle ends?
Any hip or knee appointments and/or services that occur after the bundle ends will be billed to your traditional health insurance.
What locations are included in the bundle?
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.
Is total knee replacement/total hip replacement surgery right for me?
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 orthopaedic surgeons. Together, we will determine the best course of care for your unique health needs.
What happens if I don’t clinically qualify for total knee replacement/ total hip replacement surgery?
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.
What about FMLA and short-term disability paperwork?
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.
Can I get two procedures done at the same time (both knees or knee and hip)?
Only one procedure is covered at a time. To have two surgeries covered, they must be completed separately.
I've had surgery on my knee and/or hip before. Will my revision surgery be covered by the bundle?
The bundle does not cover revision surgeries.
Who do I contact with questions?
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.