Health plans
Independent medical necessity and appeals support for medical directors and utilization teams — specialty-matched reviewers, documented COI screening, and clear written rationale.
Solutions
Clinical review that stays independent.
Focused independent medical review for health plans, TPAs, self-funded employers, and related partners across the U.S. — built to do the core work well from day one.
By partner type
Built for the buyers who need independent review.
Same core solutions — framed by who you are. No invented product SKUs or turnaround guarantees.
TPAs
A clinically independent partner for self-funded and fully insured book-of-business review workflows. Non-PHI contact covers setup. Authorized case files go through the portal after MFA.
Self-funded employers
Impartial determinations that help plan sponsors meet fiduciary expectations — physician-owned oversight and documented independence on every case.
Stop-loss & related partners
When stop-loss or related partners need independent clinical input on contested utilization questions, we can discuss the same specialty-matched review path — confirm scope at engagement. Not a current product catalog item with invented SLAs.
Providers
Treating organizations are not a consulting client. Clinicians can ask about the reviewer network. No RCM, denial-campaign, or peer-review software product.
Government
Open to conversation when the clinical question matches review we actually do. No current contracts, awards, or program designations.
Core solutions
What we deliver.
Independent medical necessity review
Impartial review of utilization decisions against the clinical record and applicable standards of care. Determinations are documented with clear clinical rationale — free from volume targets or outcome incentives.
Specialty-matched reviewers
Cases routed to clinicians whose specialty aligns with the clinical question — not a one-size panel. We are building a specialty-matched reviewer network nationwide to deepen coverage over time. We do not claim inflated headcounts or a finished national panel we do not yet have.
Appeals & external review support
Structured, appeal-ready determinations with written rationale suitable for plan processes and external review pathways. Support for partners who need independent clinical input on contested utilization decisions.
Secure cloud case portal
Secure case upload is available for authorized portal users (Business, Provider, and Admin) after MFA: a verified email and a second factor, with an authenticator preferred and US SMS supported. ArkMedis will review and process submitted cases after Texas Department of Insurance Independent Review Organization certification is issued. The application is filed and in process. Certification is not active. Send case PHI only through the portal vault. Do not send PHI by email or fax. Download of stored files is not available yet.
Service pages
Every service route, including work we do not sell.
Consulting, workers’ compensation, legal services, and a UM software product are pages on purpose. Each one says it is not offered.
Utilization review
Outside review of a utilization question. Not the plan’s UM department.
Medical necessity
Record review and a written rationale for the engaging plan or TPA.
Appeals
Rationale for a contested decision. Not a 50-state license map.
Appeals support
Shorter note on what an appeal file includes and excludes.
Medical Director
Oversight of ArkMedis determinations. Not on-demand staffing.
Specialties
Internal Medicine is Available. Other specialties are Building.
Consulting
Not offered. No accreditation or operational consulting menu.
Workers’ compensation
Not offered. Do not send comp claim files.
Legal services
Not offered. ArkMedis is not a law firm.
Software
Not offered. No UM product for sale. The portal is a case workspace.
Turnaround
Rush and standard options are available — timelines are confirmed at intake for each engagement. We do not publish invented hour or day guarantees or fake completion percentages on this site.
How engagement starts
Introductions and operational questions use non-PHI channels (Contact). Secure case upload is available for authorized portal users (Business, Provider, and Admin) after MFA: a verified email and a second factor, with an authenticator preferred and US SMS supported. ArkMedis will review and process submitted cases after Texas Department of Insurance Independent Review Organization certification is issued. The application is filed and in process. Certification is not active. Send case PHI only through the portal vault. Do not send PHI by email or fax. Download of stored files is not available yet. Workspace and Google Cloud HIPAA BAAs are already held. We do not invent turnaround percentages or network-size metrics — those will appear when they are real.