Georgia Medicaid Selects GMCF As Administrative Services Organization for Utilization and Compliance Review
Posted on: Thursday, 21 December 2006, 15:00 CST
The Georgia Medical Care Foundation (GMCF) announced today that it has been selected by the Georgia Department of Community Health (DCH) as its Administrative Services Organization (ASO) to provide Utilization and Compliance Review Services for selected Medicaid members statewide. The services provided under this contract will validate that payments made to health care providers match the services rendered, document compliance with state Medicaid provider policies, and assure that the level of care provided to Medicaid patients meets the Georgia Medicaid provider conditions of participation.
GMCF is pleased to offer the DCH Program Integrity Section an efficient and results-oriented provider review solution derived from our unique blend of broad experience in medical necessity review and claims analysis, an in-depth knowledge of Medicaid, and widely recognized clinical expertise. GMCF uses best practices and an expert approach derived from over 35 years of Medicaid health care review and evaluation services.
"We are excited about our new partnership with DCH," said Dennis White, CEO of GMCF. "Our history and successful experience with other Medicaid programs in the state illustrate that we understand the challenges that Georgia is facing."
Along with a team of highly skilled clinicians and analysts, the GMCF MedGuard™ system will be deployed as the technical solution offering tightly integrated modules for claims analysis, provider utilization and compliance review, and reporting. MedGuard leverages leading technologies to provide its Web-enabled application framework.
About GMCF
GMCF is a not-for-profit, physician-sponsored organization dedicated to continuously improving health care. In operation since 1970, GMCF provides innovative health care solutions focused on quality improvement, utilization management, program integrity, medical review, and health care outcomes research. For more than 20 years GMCF has served as the Medicare Quality Improvement Organization (QIO) for Georgia through a contract with the Centers for Medicare and Medicaid Services. For more information, please visit www.gmcf.org.
Source: Business Wire
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