Utilization Management
GCS understands how utilization management costs can rise. We have a dedicated team who follows evidence-based care guidelines and will analyze the necessity of care on a case-by-case basis as it aligns with the members’ health benefits plan.
To address this, GCS’ UM service offers the following:
Evaluation
We assess medical necessity, appropriateness, and efficiency to ensure every service meets your clinical standards—avoiding delays and unnecessary costs.
Coordination
We manage appointments, transport, and discharges so members receive timely, well-coordinated care with fewer disruptions.
Review
We verify eligibility, check copayments, and support members through appeals and grievances, simplifying access while ensuring compliance.