Fight Your Case with Data Designed to Defend 

The Medicare and Medicaid programs face fraud and abuse exposure unique to their provider eco-system. Unlike commercial payor models, the Federal and State systems operate under the Provider “honor system” some refer to as a “pay and chase” model.  Unfortunately for providers, both Medicare and Medicaid often become confused in their own complex coverage determinations with investigations triggered by outdated analytics.  

While nefarious actors target the Federal and State Payors specifically for their model of reimbursement, Medilytix provides your defense team with key analytics, physician review and strategy to help successfully expose the flaws of an over aggressive investigation, FCA/Whistleblower complaint, audit or indictment.

This data-driven intervention allows for the development of a successful defense strategy early, with the one thing the Government Payors don’t have… a team that both understands the State and Federal programs and exactly how their data and investigations are derived.