Medlogix Manages the Entire Pre-certification Process
Medlogix provides a prospective review of diagnostic tests, durable medical equipment, medical treatment and medical procedures to support auto carriers in maintaining NJ-AICRA compliance.Â
Services may include:
- Prior authorization
- Utilization reviewÂ
- Case managementÂ
We determine whether the treatment plan is medically necessary and whether it provides for the appropriate level of care consistent with clinical protocols.Â
Treatment that does not meet this criteria is escalated to a medical director. Medlogix manages the entire pre-certification process, including appeals and dispute resolution.
New Jersey is among the most complex and highly regulated states to navigate claims management.
Our experience in New Jersey and other demanding state environments helped us develop highly sophisticated solutions that can be applied seamlessly in other markets. Our commitment to excellence is evident in our partnerships with major carriers, enabling us to develop custom workflows and DPR plans tailored to their specific needs.
We are the first company in New Jersey to have their plan approved by the NJ Department of Banking and Insurance, a testament to our pioneering approach and dedication to compliance.
- Our senior executives actively advise the NJ PIP TAC Committee.
- Medlogix has provided training and guidance to insurance carriers, regulators, arbitrators, and providers on compliance and best practices.
- We offer a full complement of NJ Precertification Services within AICRA regulations and carrier plan specific rules approved by the NJ State Department of Banking and Insurance.