GCR’s three enterprise-class servers host the data warehouse, provider fee schedules, and business systems. This automated platform can instantly process an unlimited amount of claims, while our PPO network partners constantly update their data to ensure GCR’s accuracy in re-pricing. A secure, off-site backup is in place for disaster recovery and business continuity.

Conversion:
Non-electronic input are converted to electronic form

Transmission:
Electronic files are transmitted and received via a secure FTP process

Routing:
Claims are sent to GCR for re-pricing

Review:
GCR negotiators analyze claims

Delivery:
Re-priced claims are delivered to you with savings and discounting details

Repricing Just Got EasierGCR provides flexible technology scalable to your changing business needs. Each of our HIPAA compliant solutions are custom tailored to your requests and specifications.

Our Information Technology Group’s mission is to provide the highest quality Information Systems that enhance productivity and efficiency through the use of applied technology. We welcome ideas and suggestions from our customers that will add value to the exceptional services we provide. Our strategy is to use total quality management tools to continuously improve our processes, systems, and customer satisfaction.

We could have re-priced your claim in less time than it took to read this sentence.

Our system automatically accesses over 100 PPO networks for re-pricing discounts while all paper claims will be converted to electronic (837) claims for rapid interchange. PPO data is updated continuously, ensuring that we have the most current information available.

• GCR’s REDI-connect™ automated claim logging, tracking, and status reporting will be used
  
  
• OON claims will be routed to GCR’s proprietary server (GCR2) for instantaneous repricing through our networks and the savings will be delivered to you
  
  
• Any claims that did not receive a discount will be routed to backup recovery-point objectives (RPO) to achieve a discount
  
  
• Claims not receiving a discount through backup recovery-point objectives (RPO) will be sent to GCR’s experienced fee negotiators to achieve a discount
  
  
• Claim status may be checked either by logging onto our claim tracking web site or calling customer service
  
  
• GCR will maintain a routing log detailing the location and status of all claims.
  
  
• All of our claim sources have specific time horizons and GCR performs to ensure that all claims are returned on time

SystemsGCR provides flexible technology easily adapted to your changing business needs. Each of our HIPAA compliant programs are custom tailored to your unique requests and specifications.

REDI Connect ™GCR’s signature program, REDI-Connect allows clients to instantly submit and re-price claims online 24 hours a day. Enjoy access to all PPOs through a single source with the convenience of same day turnaround on re-priced EDI files.

We provide the ability to connect to all major claims systems through software bridging and strategic partnership relationships. REDI-Connect enhances connectivity, streamlines operations, and scrubs data- without the start up, annual, and transaction fees associated with traditional clearing houses. Perfect for high volume medical claims, clients can connect electronically for automatic adjudication.

REDI Connect ™

• Send and receive electronic claim data via data interface with your system
• Re-price claims
• Generate custom reports for encounter data and savings summaries
• Access discounts
• Print off claims
• ROB Discount Information
• Paperless solutions that eliminate losing claims during transfer
• Reduce the amount of rekeying claim information
• Decreased administrative costs
• HIPAA Compliant

Secondary NetworksGCR’s Information Technology Group’s mission is to provide the highest quality Information Systems that enhance productivity and efficiency through the use of applied technology. Our strategy is to use total quality management tools to continuously improve our processes, systems, and customer satisfaction. We actively solicit ideas and suggestions from our customers and distill these ideas into new value added functions for both our internal and external customers.

Bill Review and AuditGCR utilizes an inter-disciplinary team of nurses, physicians, attorneys, and fee negotiators to review claims against objective reimbursement benchmarks and standards. Unreasonable charges, code bundling, and billing errors are identified through a line item analysis, while financial, medical, and legal reimbursement considerations are integrated into every audit recommendation. An average of 44% additional savings is realized.

ASPire™  for MoreGCR’s proprietary ASP Instant Re-pricing Engine provides 24-hour access to over 2.7 million provider records auto-populated with provider billing information. ASPire serves specially tailored data entry needs, allowing full access to GCR’s extensive network discounts and professional fee negotiation services. There’s no integration, no sign up fee, and no charge unless a discount is achieved. Results are instant.

This Internet based, user friendly platform was specially designed with you in mind. Receive automatic real time repricing without entering the complete HCFA or UB.

ASPire™

• Easy data entry
• Explanation of provider remittance
• Full claim status visibility
• Immediate notification of discount
• Unlimited repricing

Fee Negotiation Fee Negotiation is a service that GCR utilizes for special claim situations. Claims that are not automatically re-priced are immediately forwarded to fee negotiation, resulting in large savings and short turn around.

GCR’s proprietary software allows negotiators to access claim history to leverage negotiating power. Supported by state-of-the-art technology and a wealth of industry knowledge, our highly qualified negotiators work with non-contracted providers to obtain the maximum discount on out-of-network claims. Settlements benefit providers by providing expedited payment, while acting as a safeguard from more erratic Usual, Customary and Reasonable cost reductions.

• 86% capture rate
• 32% average savings
• Average turn around is 1.2 business day