AllMed Healthcare Management

What AllMed Healthcare Management does

AllMed Healthcare Management is a privately held Oregon LLC founded in 1995 that operates as an Independent Review Organization (IRO) and utilization management service provider for U.S. healthcare payer organizations. The company delivers nurse prior authorization reviews, physician generalist authorization reviews, specialist authorization reviews spanning 35+ subspecialty types, independent appeals, and external appeals, with particular depth in behavioral health through a nationwide panel of board-certified psychiatrists and psychologists. Service delivery is conducted through web-based Client Portal and Peer Reviewer Portal platforms, supplemented by the ExamWorks UM Strategies workflow product for integrated prior authorization processing.

The business operates as a professional services firm, generating revenue through multi-year enterprise contracts with healthcare payer organizations including Medicare and Medicaid Managed Care Organizations, Third Party Administrators, commercial and self-insured health plans, Pharmacy Benefit Managers, and benefit carve-outs/centers of excellence. Pricing is based on per-case review fees or contracted service arrangements negotiated individually with payer clients; no public pricing or volume data is disclosed. The company holds four gating healthcare credentials — URAC IRO and HUM accreditations, NCQA Utilization Management accreditation, and HITRUST CSF certification — which are typically required for government and large commercial payer IRO engagements. Geographic reach is national within the United States only, with two disclosed Portland, Oregon office locations (headquarters at 123 NE Third Ave. and a corporate office at 111 SE 5th Ave.). Headcount sits in the 51–100 employee band, and AllMed is led by General Manager Meaghan Klassen, with a named medical director bench including a VP & Medical Director and a Behavioral Health Medical Director.

Name

AllMed Healthcare Management

Legal name

AllMed Healthcare Management, LLC

Website

https://allmedmd.com

Company type

Private

Founded year

1995

Operating status

Operating

Headcount range

51–100 employees

Short description

AllMed Healthcare Management is a Portland, Oregon-based Independent Review Organization founded in 1995 that provides utilization management, specialist clinical reviews across 35+ subspecialties, and independent/external appeals to U.S. healthcare payers including Medicare/Medicaid MCOs, TPAs, health plans, and PBMs.

Ownership category

akta.pro rank

Product category

Healthcare Utilization Management Services

NAICS

Other Ambulatory Health Care Services (6219)

SIC

Services-Health Services (8000)

akta.pro primary industry

Utilization Management (Prior Auth/Medical Necessity) Administration (HLAEALAF)

akta.pro secondary industry

Prior Authorization (ePA), Utilization Management & Coverage Verification (HLACAKAE)

Keywords

• Utilization management services
• Independent review organization
• Prior authorization reviews
• Clinical decision support
• Healthcare appeals services

Headquarters

HQ city

Portland

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others

Revenue model

1. Healthcare Utilization Review Services: AllMed generates revenue through contracted service agreements with healthcare payer organizations for utilization management and independent review organization (IRO) services. Services include nurse prior authorization reviews, physician generalist reviews, specialist reviews, independent appeals, and external appeals. Pricing is based on per-case review fees or contracted service arrangements with payer clients.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

AllMed Healthcare Management provides utilization management and independent clinical review services for healthcare payer organizations. Services include nurse and physician prior authorization reviews, specialist authorization reviews across 35+ subspecialties, independent appeals, external appeals, and behavioral health reviews. AllMed operates through URAC-accredited IRO processes and delivers reviews via a nationwide network of board-certified physician reviewers.

Product overview

AllMed Healthcare Management operates as a utilization management and Independent Review Organization (IRO) providing clinical decision-making solutions to payer organizations. The offering consists of a coordinated portfolio of core services organized around utilization management and independent review functions. Utilization Management services include Nurse Prior Authorization Reviews, Physician Generalist Authorization Reviews, and Specialist Reviews (including Behavioral Health), while IRO Services include Independent Appeals and External Appeals. The company delivers these services through its Client Portal and Peer Reviewer Portal web platforms, augmented by ExamWorks UM Strategies for integrated workflow management. All services are delivered by a nationwide network of board-certified physicians and are designed to help payer organizations ensure appropriate care, reduce overutilization, and minimize downstream appeals.

Differentiator

Problem solved

Functional benefit

Products and services

• Utilization Management
• Independent Review Organization (IRO) Services
• Nurse Prior Authorization Review Services
• Physician Generalist Authorization Reviews
• Specialist Authorization Reviews
• Independent Appeals
• External Appeals
• Behavioral Health Review Services
• ExamWorks UM Strategies

Named customers5 records

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Scale indicators2 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Kepro: Kepro provides utilization management, independent review, and care management services to government and commercial payers. It is a direct peer to AllMed in external appeals, prior authorization reviews, and IRO services.
• Medical Review Institute of America (MRIoA): MRIoA is an independent review organization offering utilization management, peer review, and external appeal services to payers and providers. It competes head-to-head with AllMed in IRO and independent appeals for government and commercial health plans.
• MCMC (Medical Case Management Consultants): MCMC is an independent review organization offering medical peer review, utilization management, and external appeal services to government and commercial payers. It is a direct competitor in the URAC-accredited IRO space.
• Dane Street: Dane Street is an independent medical review and utilization management company serving workers' compensation, group health, and disability markets. It is comparable to AllMed as a peer review and IRO service provider for payer and administrator clients.
• Advanced Medical Reviews: Advanced Medical Reviews provides independent medical peer review and utilization management services to health plans, MCOs, and TPAs. It competes with AllMed in independent review organization services and external appeals.

Broad incumbents

• Optum (UnitedHealth Group): Optum's health services platform includes utilization management, prior authorization, and care management solutions for payers and providers. As a massive, vertically integrated competitor, it overlaps with AllMed in UM technology and IRO-adjacent services.
• AIM Specialty Health: AIM Specialty Health, a Anthem/Elevance Health subsidiary, provides utilization management and specialty health management solutions to health plans and providers. It is a direct competitor in the enterprise UM and prior authorization review market where AllMed operates.
• eviCore (Carelon Medical Benefits Management): EviCore, now part of Evernorth/Cigna under Carelon, is one of the largest U.S. utilization management and specialty benefits management organizations. It is directly comparable to AllMed as an enterprise-scale UM/IRO vendor serving major payer clients with prior authorization and specialty review services.

Regional players

• Conduent Healthcare: Conduent offers utilization management, care management, and healthcare administrative services to government and commercial payers. It is comparable to AllMed as an enterprise UM services vendor though with a broader administrative portfolio.

Others

• Zelis Healthcare: Zelis provides healthcare cost management, claims administration, and payment integrity solutions to payers and providers. While broader than AllMed, it is adjacent in the payer-services ecosystem where utilization review and payment optimization intersect.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/allmedmd
• LinkedInlinkedin.com/company/allmed-healthcare-management

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about AllMed Healthcare Management