Utilization Management

Genex’s Utilization Management (UM) Services extends your overall medical strategy to every desk to easily identify excessive treatments and accelerate the delivery of appropriate care.

This Solution Helps Mitigate

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Regulatory Changes & Fines

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Lost Time & Productivity

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Control Medical Costs

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Adjuster Overload

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Siloed Data

Reduce Medical Spend

Easily identify unwarranted or excessive treatment

Unlike ineffective permissive Utilization Review processes, only Genex delivers rigorous clinical reviews, consistently applying guidelines to all claims. This reduces unnecessary medications, surgeries, diagnostics and physical therapy.

Achieve Better Outcomes

Accelerate delivery of appropriate care

With results in less than 1.7 days, our expedited decisions and treatment scheduling saves administrative time and burden, while ensuring the injured worker gets the care they need as quickly as possible. This easy-to-use process has minimal information requirements for the decision.

Reduce Medical Spend

Extend the overall medical strategy to every desk

Your customized UR program will include workflows configured by medical director standards as well as individual state regulations.  You can rely on consistent decisions, every time. Your program will be adapted to meet changing company needs and regulations.

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Fully integrated, flexible solution

Our Utilization Management Services integrated with case management, bill review, and pharmacy benefit management gives you greater control over care for injured workers and medical spend across the continuum of care.

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Meet all jurisdictional regulations

Genex has been accredited by URAC in Workers’ Compensation Utilization Management since 1996. To obtain this accreditation, we went through an in-depth and rigorous evaluation process.  Learn what it takes to achieve URAC accreditation.

You can rely on Genex’s jurisdictional expertise to meet all regulatory requirements.  In California, Genex is positioned to meet and exceed the requirements of Senate Bill 1160, particularly the accreditation mandate. Click here to access Genex’s California Filing and Policies and Procedures.

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Need to reduce your total cost of risk?

To help lower your total cost of risk and return injured workers to work as quickly as possible, we offer a FREE consultation with a workers’ comp expert. Together, we will begin to build a workers' comp program to meet your company’s unique needs.