At the center of every workers’ compensation claim is a person who suffered an injury and wants to recover from it to get back to work.

GBCARE, our medical management platform of solutions and integrated service partnerships, is engineered to provide the right level of medical management support at the right time to help injured workers on their path to recovery. 

We designed GBCARE to provide our Resolution Managers and nurses and partners with tools and best-in-class resources to support every decision and step of an injured worker’s medical recovery. GBCARE's  cost-effective solutions and decision support tools ensure the right resources are engaged at the right time. Those resources include:

  • Point of Injury Triage and Care Recommendation through PC 365
  • Waypoint Clinical Guidance
  • Pharmacy Management and Utilization Management through RX Profile, Utilization Monitoring, and Physician Engagement
  • Outcome-Based Provider Network
  • Partnerships with medical management specialists
  • Telephonic and Field Nurse Case Management

While every step in the recovery process is important, our experience resolving millions of workers’ compensation claims over 60 years reveals that certain decisions have an outsized impact on the outcome of the claim – in terms of the recovery of the injured employee, the satisfaction of the employer with the claims services, and the overall cost of the claim. For that reason, we control and manage these critical decisions, ensure that the decisions are efficiently communicated to our partners who provide supporting services and then integrate decisions and findings into their systems. This approach allows us to deliver superior outcomes – better care more cost effectively – compared to unbundled service delivery models.  

Our team is ready to help your team move forward. The ultimate goal of GBCARE and our teams is to provide high quality, seamless medical care to injured workers so they can focus on recovery. The comprehensive, integrated solutions in the GBCARE platform deliver that care whether your employee has a medical only claim, a complex traumatic injury or something in between. 

For further guidance on Certified Networks, State Direction of Care Rules and State Drug Formulary Updates, please visit our managed care plans and networks page.