HealthEdge and UST HealthProof Unite: Better Together for Success 

RADV Audits
Combined Technological Excellence

HealthEdge 
Leading payer technology with modern architecture, engineered for the AI revolution. 

UST HealthProof
Proprietary interoperability software paired with experienced, tech-enabled operations and customer-aligned economics. 

Together
Streamlined implementation of best-in-class technology and tech-enabled solutions, enabling cost transformation through experienced operations and comprehensive end-to-end offerings for payers. 

Strategic Value for Health Plans

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Measurable Operational Impact

  • Enhanced Auto-Adjudication Rates: Advanced processing capabilities reduce manual intervention   

  • Transformed Operating Margins: Data-driven cost optimization strategies deliver quantifiable ROI 

  • Streamlined Operations: Integrated technology stack eliminates redundancies and improves efficiency   

  • Superior Member Experiences: AI-enabled solutions create personalized, responsive member interactions   

Application

De-Risked Implementation Framework

Our proven methodology guides comprehensive, outcomes-focused implementations, significantly reducing the operational risk historically associated with system changeovers. Proprietary interoperability software and data hub ensure seamless integration with existing infrastructure. 

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Configurable, Scalable Architecture

Future-ready solutions designed to adapt to each payer's unique operational requirements while scaling efficiently across expanding member populations. Modern architecture supports evolving regulatory demands and technological advancement.

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Accelerated Innovation Velocity

Unified product roadmap and integrated operating model accelerates development cycles, integrates advanced AI capabilities, and expands solution offerings across the complete payer value chain.

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Industry-Leading Capabilities

AI-Enabled Technology Stack

  • Advanced predictive analytics for population health management
  • Automated risk adjustment and quality improvement workflows
  • Intelligent claims processing with enhanced accuracy
  • Real-time data insights for strategic decision-making
     

Comprehensive Payer Solutions

  • Leading payer technology, including Claims Administration, Quality Improvement, Prospective Payment Accuracy, Provider Network Management, Care Management, Member Engagement and Risk Adjustment solutions
  • Proprietary interoperability software and data hub, demonstrated to de-risk implementations
  • Experienced operations and cost transformation