Gastrointestinal Utilization Management
Right-size endoscopy, imaging, and therapy pathways while protecting access for urgent GI presentations.
Program Impact
0 %
Appropriate Endoscopy
0 %
Pre-op Optimization
0 %
Auto-Auth Requests
0 %
Avoided Repeats
Request mix by pathway (last 12 months)
share of ordered servicesSlight shift from colonoscopy toward EGD and abdominal imaging; overall mix remains balanced.
Snapshot
- Median decision time21m
- Same-day P2P available98%
- Avoided prep repeats-9%
- Member escalations↓ 22%
Modules
Indication Triage
Screen for red-flag symptoms; fast-track urgent indications.
Prep & Follow-up
Standardized instructions reduce cancellations and repeats.
Auto-Auth
Deterministic rules for common, guideline-clear requests.
Peer Review
GI subspecialists available for rapid P2P.
Coordination
Scheduling handoffs to keep access moving.
Insights
Ordering patterns, turnaround, and member experience.