Government

medlitix delivers high-quality external appeal services to over 20 government organizations, ensuring compliance with state and federal regulations. Medlitix serves all lines of business, including Medicare, Medicaid, ACA Exchanges, Duals, and State and Federal entities.  

Our board-certified physician peer reviewers—actively licensed and practicing—conduct comprehensive case determinations with the highest standards of quality and evidence-based medicine. We take exceptional care in gathering provider and member documentation, ensuring all relevant evidence informs each appeal. Strict protocols for member and provider communication further uphold our commitment to accuracy and integrity.  

By offering professional clinical and utilization review services alongside data-driven insights, we help our clients improve member outcomes, achieve quality metric goals, and maintain payment integrity. With deep expertise in clinical review for external appeals and a forward-thinking approach, we continuously refine our processes and technology to maximize evidence-based quality for our clients.