CareReview / Who We Serve / Government Programs
Independent Review for Government Programs
Clinical review built to the compliance standards Medicare, Medicaid, and other government programs require.
Independent Review for Government Programs
Clinical review built to the compliance standards Medicare, Medicaid, and other government programs require.
CareReview provides independent, URAC-accredited clinical review supporting Medicare Advantage and Medicaid managed care organizations — including prior authorization, peer-to-peer, and internal appeal review — meeting the compliance standards public-sector programs require. Our review process applies the same evidence-based, specialty-matched rigor we bring to every line of business, backed by URAC IRO accreditation and multi-state licensure.
Independence and Accreditation, in Government Terms
Government programs — Medicare Advantage, Medicaid managed care, and other public-sector plans — operate under some of the strictest independence and compliance requirements in healthcare. CareReview's credential set is built for that level of scrutiny: URAC IRO accreditation, a HITRUST R2 certification, and multi-state licensure combine into a profile built for public-sector review, not just commercial payer standards. See our Accreditations & Compliance page for the full detail.
View Accreditations & ComplianceHow Engagement Works for Public Entities
Working with CareReview follows a consistent process regardless of payer type — Medicare Advantage, Medicaid managed care, or another public-sector program: cases are submitted through Stradix®, matched to a specialty-credentialed reviewer, and returned with a written, evidence-based determination — fully documented for audit and compliance review.