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Solutions that reduce cost and protect members.

Built for carriers managing cross-border risk: network access, claims administration, clinical oversight and pharmacy coordination working together in one coordinated partner.

Cost containment Network access Pharmacy / PBM Claims administration Actuarial reporting

Connected GRH solutions

Five connected solutions for care, claims and cost.

Global Reach Health brings claims administration, provider networks, clinical oversight, pharmacy benefit support, specialty medications and cross-border care coordination together through one integrated partner.

Network Access

One relationship. Multiple layers of provider access.

GRH gives payers coordinated access to major U.S. provider access networks, regional and international networks, and private direct relationships with hospitals, clinics, pharmacies and other providers.

How it creates value

Matches the case to the appropriate network, provider and site of care.
Expands geographic and specialty access without separate operating relationships.
Combines contracted access with direct provider options when the case requires it.
Uses provider direction and negotiation to help control avoidable cost.

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GR Insurance Electronic Gateway

Connect payer rules, network access and provider transactions.

GR Gateway creates a secure operating connection for eligibility, benefit mapping, authorizations, claims, acknowledgments and status information.

How it creates value

Reduces manual handoffs between payer, TPA, network and provider.
Creates a clearer path for eligibility and claims information.
Supports U.S. market access for international benefit programs.
Improves traceability while reducing preventable errors and rework.

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Claims Administration

Manage the claim with the full case in view.

GRH connects claim intake and adjudication support with eligibility, benefit rules, provider documentation, pricing, clinical activity and payment coordination.

How it creates value

Validates member, benefit and claim information before processing.
Applies duplicate controls, pricing logic and documented review.
Reduces leakage, avoidable reprocessing and unclear handoffs.
Returns a traceable audit trail and payer-ready reporting.

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PBM, Pharmacy & Specialty Medications

Control pharmacy cost without compromising necessary access.

GRH combines PBM capabilities, clinical oversight and proactive management of specialty and recurring high-cost therapies.

How it creates value

Supports formulary optimization and clinically appropriate lower-cost alternatives.
Uses prior authorization and utilization review to identify duplication or inappropriate use.
Evaluates specialty medications, infusion setting and other site-of-care opportunities.
Analyzes utilization trends, high-impact drugs and measurable savings opportunities.

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GR Clinic & Clinical Coordination

Connect clinical judgment to utilization and cost.

GR Clinic and the GRH clinical team support outpatient care, follow-up, complex cases, hospital activity and transitions across the member’s full care journey.

How it creates value

Directs members toward appropriate providers and sites of care.
Coordinates records, authorizations, follow-up and treatment continuity.
Supports complex, catastrophic and recurrent cases before fragmentation grows.
Helps avoid unnecessary services and higher-cost settings when clinically appropriate.

See GR Clinic

Global Reach Pharmacy

Medication access designed to reduce avoidable cost.

Pharmacy expense grows when benefits, prescriptions, specialty therapies and member support are handled in separate workflows. GRH brings them together with PBM operational oversight and practical coordination.

Formulary & alternatives

Promote clinically appropriate, lower-cost therapy options when available.

Prior authorization & review

Identify duplication, inappropriate use, safety concerns and benefit requirements.

Specialty medication oversight

Manage recurring and high-cost therapies with closer clinical and operational review.

Site-of-care optimization

Evaluate appropriate settings for infusions and provider-administered medications.

Clinical coordination

Work with prescribers and pharmacies to identify cost-effective treatment pathways.

Trend & savings analysis

Surface high-impact drugs, utilization patterns and actionable savings opportunities.

GRH also coordinates complex pharmacy cases, treatment continuity and, when appropriate, international medication delivery.

Medication and treatment decisions remain subject to the member’s benefit plan and the direction of the treating clinician.

Global Reach Clinic

Clinical access connected to the entire case.

Global Reach Clinic gives members a coordinated point of care while keeping the payer, clinical team, provider network and claims workflow aligned.

Outpatient evaluation and clinical coordination.
Navigation to an appropriate provider and site of care.
Follow-up support across authorizations, records and referrals.
Continuity with GRH case management, pharmacy and claims teams.

A connected care experienceLess fragmentation for the member. Better operational visibility for the payer.

Global Reach Health leadership and team at the Global Reach Clinic inauguration — Global Reach Clinic inauguration · Doral, Florida

FAQ

Common questions from carriers.

How does GRH reduce medical claim costs?

Through network access and repricing, provider negotiation, utilization and medical-necessity review, and catastrophic case management — combined into one coordinated program.

How do you control pharmacy costs?

Through formulary optimization, clinically appropriate alternatives, prior authorization, utilization review, specialty medication oversight, site-of-care evaluation, prescriber and pharmacy coordination, and analysis of high-impact drugs and savings opportunities.

Which provider networks do you offer?

Access to major U.S. provider access networks, regional and international partners, and a private worldwide provider network.

How do you process claims?

With AI-assisted adjudication and a full audit trail for faster, more accurate processing and fewer leakage points.

Design a program around measurable savings.

Request a savings review and we’ll map the right networks, oversight and reporting for your book.

Request a savings review