One Fully Integrated Platform for Medical Claims Management
The MyMedlogix platform for medical claims management is engineered to improve decision-making, maximize efficiencies, and enhance outcomes for both Workers’ Compensation and Auto Liability medical claims. The Medlogix platform is designed to make onboarding our system as seamless and easy as possible.
Unlike other solutions, MyMedlogix connects all essential services—such as Bill Review, PPO, Code Review, Medical Management decisions, IME, and Peer Review to name a few, —into a single fully integrated platform.
Provider Analysis
Provides visibility into key provider activity metrics across all claims and ranks providers for possible SIU intervention.
Medlogix Provider Analysis helps carriers transform provider data into actionable intelligence through advanced analytics, benchmarking, and real-time visibility into billing behavior, treatment trends, and network performance.
Provider SIU Manager
Allows SIU teams to flag and define automated rules for the handling of providers under SIU investigation.
Medlogix Provider SIU Manager helps carriers identify and investigate suspicious provider activity through integrated analytics, workflow automation, and provider-focused investigative intelligence across the medical claims lifecycle.
Dispute Manager
An Interactive solution to process and track Civil Suit, Arbitration and Pre-Suit legal matters.
Medlogix Dispute Manager helps carriers streamline appeals, arbitration, and payment dispute workflows through centralized documentation, workflow automation, and integrated clinical and operational decision support.
Workflow Monitor
Provides visibility into the status, age and responsibility of every pending workflow action.
Medlogix Workflow Monitor provides real-time visibility into medical claims operations, helping carriers proactively manage workflow performance, improve operational efficiency, and maintain consistent service execution across the life of a claim.
PPO Manager
Provides automated access to over 1.2 million national providers across numerous PPO networks.
Medlogix PPO Manager helps carriers optimize network performance, maximize savings, and improve payment consistency through intelligent PPO application, configurable network logic, and integrated provider management workflows.
CPT Rule Manager
Manages all system and client-specific rules for provider services applied during automated bill adjudication to either deny, adjust or flag services for additional review.
Medlogix CPT Rule Manager gives carriers configurable control at the procedure-code level, helping automate when bills should flow straight through, stop for documentation, route for clinical review, trigger jurisdictional handling, or escalate for further investigation. By combining CPT logic with claim data, state rules, and client-specific workflows, Medlogix helps claims teams make faster, more consistent, and more defensible medical payment decisions.
Diagnosis Manager
Manages all diagnoses both related and un-related to claims for automated handling during bill adjudication.
Medlogix Diagnosis Manager brings diagnosis-level intelligence directly into the medical claims workflow, helping carriers automate clinical triggers, identify high-risk treatment patterns, and make faster, more consistent, and more defensible claim decisions.
Care Plan Manager
Manages all information related to Pre-certification requests including nurse and doctor decisions, associated rationale and outcome rules for application during automated bill adjudication.
Medlogix Care Plan Manager helps carriers bring structure, visibility, and clinical coordination to complex medical claims by integrating treatment oversight, medical management workflows, and care-plan intelligence into a single connected claims process.
Professional Review Manager
Manages all information related to securing, scheduling and completing IME and Peer Reviews including outcomes delivered to the UR Manager in the form of automated rules.
Medlogix Professional Review Manager streamlines the coordination and oversight of IMEs, peer reviews, utilization reviews, and physician-driven services, helping carriers make faster, more consistent, and more defensible medical claims decisions.
UR Manager
Manages automated rules for the Bill Review process based on the outcomes of IME, PEER and Utilization Reviews performed within the Professional Services and Care Plan Managers.
Medlogix UR Manager helps carriers streamline utilization review operations by combining clinical intelligence, workflow automation, and evidence-based decision support into a single integrated medical management platform.
CPT Rule Manager
Manages all system and client-specific rules for provider services applied during automated bill adjudication to either deny, adjust or flag services for additional review.
Medlogix CPT Rule Manager gives carriers configurable control at the procedure-code level, helping automate when bills should flow straight through, stop for documentation, route for clinical review, trigger jurisdictional handling, or escalate for further investigation. By combining CPT logic with claim data, state rules, and client-specific workflows, Medlogix helps claims teams make faster, more consistent, and more defensible medical payment decisions.
Diagnosis Manager
Manages all diagnoses both related and un-related to claims for automated handling during bill adjudication.
Medlogix Diagnosis Manager brings diagnosis-level intelligence directly into the medical claims workflow, helping carriers automate clinical triggers, identify high-risk treatment patterns, and make faster, more consistent, and more defensible claim decisions.
Care Plan Manager
Manages all information related to Pre-certification requests including nurse and doctor decisions, associated rationale and outcome rules for application during automated bill adjudication.
Medlogix Care Plan Manager helps carriers bring structure, visibility, and clinical coordination to complex medical claims by integrating treatment oversight, medical management workflows, and care-plan intelligence into a single connected claims process.
Professional Review Manager
Manages all information related to securing, scheduling and completing IME and Peer Reviews including outcomes delivered to the UR Manager in the form of automated rules.
Medlogix Professional Review Manager streamlines the coordination and oversight of IMEs, peer reviews, utilization reviews, and physician-driven services, helping carriers make faster, more consistent, and more defensible medical claims decisions.
UR Manager
Manages automated rules for the Bill Review process based on the outcomes of IME, PEER and Utilization Reviews performed within the Professional Services and Care Plan Managers.
Medlogix UR Manager helps carriers streamline utilization review operations by combining clinical intelligence, workflow automation, and evidence-based decision support into a single integrated medical management platform.
PPO Manager
Provides automated access to over 1.2 million national providers across numerous PPO networks.
Medlogix PPO Manager helps carriers optimize network performance, maximize savings, and improve payment consistency through intelligent PPO application, configurable network logic, and integrated provider management workflows.
Workflow Monitor
Provides visibility into the status, age and responsibility of every pending workflow action.
Medlogix Workflow Monitor provides real-time visibility into medical claims operations, helping carriers proactively manage workflow performance, improve operational efficiency, and maintain consistent service execution across the life of a claim.
Dispute Manager
An Interactive solution to process and track Civil Suit, Arbitration and Pre-Suit legal matters.
Medlogix Dispute Manager helps carriers streamline appeals, arbitration, and payment dispute workflows through centralized documentation, workflow automation, and integrated clinical and operational decision support.
Provider SIU Manager
Allows SIU teams to flag and define automated rules for the handling of providers under SIU investigation.
Medlogix Provider SIU Manager helps carriers identify and investigate suspicious provider activity through integrated analytics, workflow automation, and provider-focused investigative intelligence across the medical claims lifecycle.
Provider Analysis
Provides visibility into key provider activity metrics across all claims and ranks providers for possible SIU intervention.
Medlogix Provider Analysis helps carriers transform provider data into actionable intelligence through advanced analytics, benchmarking, and real-time visibility into billing behavior, treatment trends, and network performance.
“The integration was seamless and relatively easy. Their service and responsiveness are excellent. I was impressed by the involvement of their team.” Management Specialist Client
Clients experience a smooth transition with minimal disruption
Our system’s ease of use, adaptability, and intuitive design, minimize disruption during the transition. MyMedlogix adapts to the unique needs of each client.
Our in-house development, QA and support staff members average more than 16 years of experience, so they understand the challenges you face.
We do more than transition processes and technology - we solve systems gaps and pain points that need to be addressed.
Fully Integrated Proprietary Medical Claims Management Solution
- Securely manage all activity 24/7/365
- Workflow and role driven - tracks status of every job real-time
- Customizable Rules Engines
- On-demand report generation
- Sophisticated data analytics and benchmark reporting
- User configurable dashboards and visualizations
- We adapt to your data and manage integration
We understand every organization is unique
- Individualized workflows—even at the adjuster level
- Custom solutions for both Workers’ Comp and Auto Liability
- Solve existing process pain points like staff productivity and cost pressures
- Deliver rapid platform updates—changes in days, not months
- Provide exceptional document management for total organization
With MyMedlogix, you’re not just buying software—you’re gaining a partner
- We build strong client relationships
- Our own PPO network delivers added value
- Comprehensive state-specific expertise for the most complex jurisdictions
- Consistently meets or exceeds SLAs and benchmarks
99.997% System Uptime
Millions of EDI transactions monthly – billions in claims managed.
Make better decisions with integrated analytics:
- Real-time reporting from the MyMedlogix portal
- Benchmark tracking to measure performance
- Data visualizations that highlight trends and opportunities
- Actionable insights to improve accuracy, efficiency, and timeliness
- Business intelligence that identifies hidden value across service lines
Contact us about our integrated, user-friendly platform gives you a powerful medical claims management system.
