Northwood

What Northwood does

Northwood, Inc. is a privately held third-party administrator (TPA) founded in 1992 and headquartered in Madison Heights, Michigan, providing claims administration and benefit management services for durable medical equipment (DME), prosthetics and orthotics (P&O), medical supplies, pharmacy benefits, and ancillary home health services to insurance carriers across health plans, Michigan auto no-fault, and workers' compensation lines of business. The company operates a claims administration platform anchored by a proprietary pre-authorization process that reviews every physician-prescribed service for injury-relatedness before approval — a methodology differentiated from formulary-based competitors — and supports it with a credentialed U.S. provider network of more than 5,800 locations and a national pharmacy network exceeding 55,000 providers.

Revenue is generated through managed-services fees paid by insurance carriers under multi-year contracts, with quote-based B2B pricing not publicly disclosed. The go-to-market motion is enterprise field sales targeting insurance company claims departments, supplemented by phone-based consultation, an online referral portal for case intake, and thought-leadership content marketing. NCQA and URAC accreditations provide regulatory credibility, and a 24/7 customer care line supports claimants, adjusters, and examiners through the claims lifecycle.

The company is founder-owned and operated by Ken Fasse (President and CEO since inception), with no disclosed external private equity, venture capital, or parent company ownership. Northwood carries healthcare-specific compliance credentials, integration capability with claims payment systems, and a service portfolio spanning home modifications, infusion services, transportation, and translation — making it a vertically integrated TPA focused on cost containment and claimant experience for the property-and-casualty and workers' compensation insurance markets.

Name

Northwood

Legal name

Northwood, Inc.

Website

https://northwoodinc.com

Company type

Private

Founded year

1992

Operating status

Operating

Headcount range

101–250 employees

Short description

Northwood is a Michigan-based third-party administrator providing claims administration and benefit management for DME, prosthetics/orthotics, medical supplies, pharmacy, and ancillary home health services to health plans, auto no-fault, and workers' compensation insurance carriers across the United States.

Ownership category

akta.pro rank

Product category

Healthcare Claims Administration (Third-Party Administrator Services)

SIC

Orthopedic, Prosthetic & Surgical Appliances & Supplies (3842)

akta.pro primary industry

Utilization Management, Appropriateness Criteria & Prior Authorization CDS (HLACAGAM)

Keywords

• Claims administration services
• Pharmacy benefit management
• Durable medical equipment administration
• Workers' compensation administration
• Auto no-fault claims

Headquarters

HQ city

Madison Heights

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

Revenue model

1. Third-Party Administration Services: Northwood acts as a TPA providing DME, P&O, pharmacy and ancillary services administration for health plans, auto no-fault, and workers' compensation insurance companies. Revenue derived from service fees for claims administration, pre-authorization, and network access.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Northwood is a third-party administrator that administers durable medical equipment, prosthetics, orthotics, medical supplies, pharmacy benefits, and ancillary home health services for health plans, auto no-fault insurance carriers, and workers' compensation payors. The company applies a proprietary pre-authorization process to every physician-prescribed service to verify injury-relatedness before approval, and coordinates service delivery through a credentialed national provider network of 5,800+ locations and 55,000+ pharmacies.

Product overview

Northwood is a third-party administrator (TPA) providing integrated DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies), pharmacy benefit management, and ancillary home health care services for health plans, auto no-fault insurance, and workers' compensation payors. The company operates a core platform of claims administration and benefit management services, supported by its proprietary pre-authorization process and credentialed provider network spanning the United States. The product portfolio includes Health Plans/Benefit Management for DME/P&O/Medical Supplies, Auto No-Fault Claims Administration, Workers' Compensation Claims Administration, Pharmacy Benefit Management (PBM) with a network of 55,000+ pharmacies, Home Health Services, Infusion Services, Transportation Services, Translation Services, and Home Modifications. Key differentiators include pre-authorization on all physician-prescribed services to ensure injury-relatedness, a provider network with over 5,800 locations, 24/7 customer care line, and NCQA/URAC accreditation.

Differentiator

Problem solved

Functional benefit

Products and services

• Health Plans Benefit Management (DME/P&O/Medical Supplies) Core benefit management service for health plans, administering durable medical equipment, prosthetics, orthotics and medical supplies for self-insured employers and health plan sponsors, including pre-authorization, provider network access, and adjudication.
• Auto No-Fault Claims Administration Third-party administrator services for Michigan auto insurance companies and their injured claimants, handling automobile no-fault claims with pre-authorization, provider network access, and care coordination.
• Workers' Compensation Claims Administration Managed home health care products and services for workers' compensation carriers and injured workers, including claims adjudication support, provider coordination, and cost containment.
• Pharmacy Benefit Management (PBM) Pharmacy benefit manager services including a national pharmacy network of over 55,000 providers, pre-authorization for injury-related prescriptions, utilization reviews, and compound medication billing.
• Home Health Services Coordination of home health care products and services for claimants including nursing, therapy, and personal care support.
• Home Modifications Home modification services for catastrophically injured claimants to accommodate disability-related needs.
• Infusion Services IV medication and infusion therapy services for claimants requiring specialized pharmaceutical administration.
• Transportation Services Medical transportation coordination for claimants needing rides to medical appointments and providers.
• Translation/Interpretation Services Language translation and interpretation services for claimants with limited English proficiency.

Quantifiable outcome

• Elimination of out-of-pocket costs for claimants on injury-related services
• +3 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Scale indicators2 records

Recent moves4 records

Expansion highlights4 records

Broad incumbents

• Express Scripts (Evernorth): Major PBM that Northwood competes with for pharmacy benefit management in auto no-fault and workers' comp — though at vastly larger scale and with a broader payer mix.
• Coventry Workers' Comp Services: Workers' compensation PPO and managed care network provider — competes with Northwood in delivering network access, pre-authorization, and cost containment to carriers.
• OptumRx: Vertically integrated PBM serving health plans, auto, and workers' comp — competing with Northwood's PBM line and adjacent DME/ancillary services at national scale.
• Sedgwick: Large, diversified claims management and TPA serving workers' comp, auto, and disability — overlapping with Northwood across verticals but operating at national scale with broader service lines.

Direct peers

• MedRisk: National managed care organization specializing in physical therapy and DME for workers' compensation — competing directly with Northwood's workers' comp DME and ancillary service offering.
• GENEX Services: Provider of managed care and clinical services for workers' compensation, auto liability, and disability — a direct competitor across Northwood's core verticals with overlapping claims administration capabilities.
• Bardavon Health Innovations: Workers' compensation-focused network and care management provider for PT, DME, and occupational health — directly comparable to Northwood's workers' comp DME and ancillary services.
• Mitchell International: Technology and managed services company for the auto insurance and workers' comp claims industry — directly comparable to Northwood's auto no-fault and workers' comp administration services.
• One Call Care Management: Specialty managed care TPA for workers' compensation providing physical therapy, DME, diagnostic, and transportation services to carriers — closely matches Northwood's ancillary services portfolio and payer base.
• PMSI / Optum Workers' Comp: PMSI (acquired by Optum) is one of the largest TPAs administering DME, PBM, and ancillary services specifically for workers' compensation carriers — directly competing with Northwood's workers' comp vertical on the same buyer set.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/northwood_inc
• LinkedInlinkedin.com/company/northwood-inc

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 Northwood