The MedCom Utilization Management Program establishes an integrated, comprehensive, and systematic approach to the assessment of the important aspects of healthcare, the monitoring and evaluation of key indicators, and the improvement of healthcare services provided to participants.

• Increases health plan value for your company and plan participants by helping to determine the medical necessity of prescribed treatment or care
• Improves health outcomes through personalized care and monitoring
• Effective plan utilization can help reduce re-insurance and employee premiums while managing overall health plan costs
• Enhances employee benefits package by providing your plan participants resources that evaluate their care and help them avoid unnecessary medical expenses
• Standard utilization review processes allow for participants to receive rapid review and certification of services
• Encourages utilization of in-network providers and services in an effort to reduce participant and plan exposure to uncovered charges
• Real-time networked software between MedCom's and Gilsbar's claim and customer service departments provides faster claims processing, updated patient notes and accurate eligibility information
• Increases employee satisfaction and retention by offering an enhanced benefits package, attentive service and rapid review of treatments

For additional information on Utilization Management, please call MedCom Care Management, Inc. at 1-800-643-4416 or contact us by email today.

MedCom does not engage in the practice of medicine; nor does it act to impinge upon or encumber the independent medical judgment of treating physicians or other health care providers. Implementation of this program should not be construed to imply otherwise.