WHO WE SERVE
Solutions Built for Health Plans & Managed Care
Medlitix helps health plans meet their most demanding utilization management and independent review requirements — with the clinical expertise, accreditation, and turnaround times your teams depend on.
What's included
Utilization Management
Prior authorization, initial reviews and appeal reviews across all levels — delivered by board-certified physicians meeting all state and federal UM timeframes.
Independent Review Organization
URAC-accredited external review services for final binding appeal determinations across commercial, Medicare, Medicaid and ACA exchange plans.
Pharmacy Reviews
Formulary exception, step therapy override and specialty drug reviews by clinical pharmacists and board-certified physicians.
Workers’ Compensation
Peer and pharmacy reviews with state-licensed specialty-matched providers and jurisdictional rule management built in.
Auto & Liability Reviews
Medical necessity, causality and demand package reviews supporting auto and liability claims adjudication.
Government Program Support
Clinical review services for Medicaid, Medicare, ACA exchanges and dual-eligible programs meeting all applicable regulatory requirements.
Who we serve
medlitix partners with health plans of all sizes across commercial, government and specialty lines.
→ Commercial Health Plans
→ Managed Care Organizations
→ Medicare & Medicaid Plans
→ ACA Exchange Plans
Why health plans choose Medlitix
URAC-accredited IRO
120+ physician specialties
Meets all state & federal UM timeframes
Weekend & holiday coverage available
Ready to streamline your review process?
Submit a referral today or reach out to explore how medlitix can support your team.