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Medicaid Management

Medicaid Management

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Previous Flipbook

Cost Containment & Care Quality - Payment Integrity, Utilization Management and Care Management
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Care Management - Utilization Management Module

Our Utilization Management Module allows you to monitor prior authorizations, inpatient stays and concurrent and retrospective reviews. Learn how we can help your organization do more with less.

Most Recent Flipbooks

3 months ago
Claims, Encounters & Financials Solution Overview

Gainwell's Claims, Encounters and Financials solution enables Medicaid fee-for-service and managed care entities to accurately and efficiently process large volumes of claims, saving billions.

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4 months ago
Provider Solutions Overview

Provider Solutions from Gainwell streamline the process of screening and enrolling Medicaid providers, equipping them to deliver high-quality healthcare services. Discover the features and benefits.

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5 months ago
Immunization At-A-Glance

Gainwell's modern Immunization Solution supports states with accurate immunization data, compliance with industry requirements and smarter decision-making. Discover the benefits and results.

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5 months ago
Comprehensive Coordination of Benefits

Gainwell's comprehensive, compliant and configurable Coordination of Benefits (COB) solution maximizes available coverage for consumers while preserving healthcare dollars for states and health plans.

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6 months ago
Integrated Eligibility - GainwellAssist™ Overview

Overcome disparate data systems and silos to understand the full scope of recipient needs and connect people to the services for which they are eligible. Discover Integrated Eligibility from Gainwell.

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8 months ago
Provider Portal

Gainwell’s self-service portal streamlines healthcare operations for providers and administrators, offering access to round-the-clock support.

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8 months ago
Provider Management

Streamline provider enrollment, relations and contracting with Gainwell’s integrated commercial-off-the-shelf module.

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8 months ago
Provider Enrollment Screening

Gainwell's Provider Enrollment & Screening solution simplifies clinician enrollment, meets federal requirements and offers cost-saving features for Medicaid agencies.

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9 months ago
GainwellGo™

Discover the innovative digital solution providing Medicaid members with easy, secure access to their health data. See how GainwellGo is enhancing patient experiences while reducing costs for states.

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12 months ago
Audit & Quality Management

Take the stress out of audits and build quality assurance and control in your processes. Gainwell's Whole Person Service Audit & Quality Management helps agencies manage audit findings. Discover now.

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about 1 year ago
Early Intervention Family Portal Overview

Discover an innovative early intervention family portal that empowers caregivers of children with developmental delays. Track progress, access resources and communicate with ease. Learn more now.

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about 1 year ago
FraudCapture®

Gainwell Technologies uses cutting-edge tech to deliver future-ready fraud solutions. We combine innovation & experience to provide value beyond the margins of today's healthcare landscape.

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about 1 year ago
At A Glance - Gainwell Technologies

Gainwell Technologies is the leading provider of digital and cloud-enabled solutions to health and human services programs, supporting 56 million Medicaid beneficiaries.

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Preferred Drug List Management

Our dynamic and forward-looking approach to developing Preferred Drug Lists can help you reduce overall pharmacy expenditures and provide the best clinical value.

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Pharmacy Point-of-Sale

Our Pharmacy Point-of-Sale solution can help you control budget spend and administrative resource time while meeting federal and state requirements.

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Provider Solutions - Provider Credentialing

Centralized provider credentialing gives states control over the credentialing process, allowing enrolled Medicaid providers to be credentialed only once, saving money and reducing abrasion.

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Pre-payment Solutions

Gainwell's pre-payment solutions are comprehensive, compliant & configurable. See how we can help your organization minimize abrasion, alleviate administrative burden, and reduce claim spend.

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Enterprise Data Warehouse

Our centralized, cloud-based platform gives you the power of master data management, business intelligence & transformational analytics offerings that range from basic to advanced predictive modeling.

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PHE Unwinding - Whole Person Service

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over 1 year ago
Eligibility Verifications

Gainwell's comprehensive eligibility verification solutions include dependent eligibility, pension beneficiary, point of enrollment, working spouse provision, residency & non-smoking verifications.

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