Who this is for
TPAs that manage utilization and appeals for self-funded groups, fully insured business, or both, and need an outside clinical review they can explain to clients.
- Employer groups expect a consistent independent review path, not a different story for each account.
- Clients ask about seals and statistics. We will not invent either. BAAs held is not the same thing as a live PHI portal.
- Email threads between a TPA and an IRO are the wrong place for case records.
- A single published turnaround percentage does not survive contact with real files. We confirm timing at intake instead.
What ArkMedis does for you
- Medical necessity review for the clinical questions you send once intake is open for PHI.
- Appeals support with a written rationale the plan process can carry. We are a Texas TDI IRO applicant, not a certified IRO, and we do not claim other external-review licenses.
- Specialty alignment under Medical Director oversight. See the coverage matrix — Internal Medicine Available; other specialties Building.
- Dual channel by design: Contact for setup. Portal sign-in requires MFA (verified email and a second factor). 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. Audit logging is stdout only and is not a retention program.
Stop-loss carriers and related partners can ask about the same review path. Scope is confirmed at engagement. We do not publish a separate product with invented service levels.
How intake works
Operational setup without records
Introduce the book of business, the clinical question types, and who the determinations return to. Keep names of members and clinical detail out of email and fax.
Per-file timing
Standard or rush is chosen when a file is actually accepted. We do not advertise hour or day guarantees on this site.
Records later, and only in the 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. Google Cloud and Workspace HIPAA BAAs are held. Those agreements are not TDI certification.
Independence and conflict of interest
Physician ownership and MD Medical Director accountability apply to every book of business. Conflict-of-interest screening is documented before clinical work. Reviewers are not paid on outcomes, and we do not set volume targets that would pressure a determination.
Leadership is President and Medical Director — see Leadership. We do not use couple or family framing. National operations, Houston primary office.