01
Provider negotiation
Repricing and direct negotiation against billed charges to reduce leakage on out-of-network and cross-border claims.
For insurers, TPAs & assistance companies
Cost containment and actuarial-ready visibility.
Give your claims, finance and actuarial teams a single partner for cross-border network access, disciplined utilization oversight and reporting that supports pricing, reserving and trend analysis.
What carriers get
Levers that reduce cross-border spend.
Every engagement combines network access, clinical oversight and pharmacy coordination to remove unnecessary cost while protecting members.
02
Utilization oversight
Proactive medical-necessity and utilization review that flags avoidable spend before it is incurred.
03
Pharmacy & PBM optimization
Specialty drug cost control with PBM reporting on utilization, trends and savings opportunities.
04
Catastrophic case management
Clinical management of high-cost, complex cases with reserve visibility and coordinated care.
05
AI claims adjudication
AI-assisted adjudication with a full audit trail, faster processing and fewer manual errors.
06
Multilingual member support
Coordinated, multilingual member assistance that improves experience and steers care in-network.
For actuarial & underwriting
Data your pricing teams can actually use.
GRH consolidates medical, pharmacy and utilization data into structured reporting designed for actuarial and finance workflows.
- Cost and utilization reporting by cohort, geography and service line.
- Trend and loss-ratio inputs for pricing and reserving.
- Savings attribution across negotiation, PBM and utilization oversight.
- Catastrophic case flagging with reserve impact visibility.
- Sample PBM and claims-adjudication reports on request.
15–35%spend reduction
<24hcase response
100%audit trail
- Claims & utilization dashboards
- PBM trend & savings reporting
- Reserve & catastrophic visibility
- Actuarial-ready data exports
How we engage
From savings review to measurable results.
1
Savings review
We assess current cross-border spend, networks and leakage points.
2
Program design
Network access, oversight and PBM levers tailored to your book.
3
Integration
Claims routing, portal access and reporting aligned to your teams.
4
Reporting
Ongoing cost, utilization and savings reporting for finance and actuarial.
3major U.S. networks
15–35%cost reduction potential
100%claims audit trail
24/7catastrophic oversight
Put a cost-containment partner behind your book.
Request a savings review and we’ll show your team the networks, oversight and reporting that reduce cross-border spend.