Gabe Hynes, Utilization Reviewer, joined the Morningside Recovery team in 2014, having worked in various positions within the field of recovery for well over a decade..
After getting sober himself nearly 16 years ago, he used his studies and interest in psychology to work his way up in the recovery industry. He traveled for 8 years around the country as a full-time interventionist and has held several positions on both the clinical and operational sides of treatment at facilities in Florida and Southern California.
Having “done it all,” Gabe now integrates his experience and breadth of knowledge as a liaison between Morningside case managers and insurance companies as our utilization reviewer. He communicates directly with therapists and insurance agents in order to ensure that clients meet medical necessity so they may reap every benefit available to them. This work as an essential aspect of case management that spans from pre-certification to concurrent administration of health care services to retrospective review. For clients, this involves pre-authorization of certain therapies and services that are deemed appropriate by their primary therapists as their needs change over the course of treatment. The negotiation of benefits is constant, as a client’s mental health status changes and progresses over the course of their stay.
In short, Gabe is both a Morningside representative and client advocate. He not only makes our quality of care better by lifting this task off of therapists’ shoulders, but plays a key role in helping our clients get the help they desperately need.