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About us

We are trusted allies of health plans and organizations, simplifying their complex operational and quality challenges across all lines of business

Who we are

Market leaders with a commitment to excellence in healthcare technology and outcomes

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Our Leadership

Our team of dynamic thought leaders and innovators, driving transformative change in healthcare technology

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Join our team

Work with us to unburden healthcare and improve people’s health and wellbeing

JOIN US

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What we offer

PRODUCT AND SOLUTIONS

BPaaS Ecosystem

Integrated ecosystem of best-in-class, scalable, turnkey solutions for health plans across all lines of business

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HIGHLIGHTS

Our BPaaS advantage

Move from the burden of fragmented legacy systems to scalability, efficiency, and predictable outcomes

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Our approach

How we consistently deliver value and earn the trust of our clients

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Solution finder

Discover what works best for you. Use our intuitive solution finder tool to navigate through our suite of offerings and uncover tailored solutions designed just for you

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Core Administration

Suite of leading-edge core admin solutions designed to deliver outcomes with reduced costs across multiple lines of business

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SOLUTION GROUPS

Enrollment Plus™

Streamline enrollment processes and increase member satisfaction

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Engagement Plus®

Next best actions for data-driven personalized care

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Integration Plus™

Seamlessly integrate all your systems and data​

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Workflow Plus®

Automate and optimize operations

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Insitz Plus

Operational insights, better and faster​

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Solution finder

Discover what works best for you. Use our intuitive solution finder tool to navigate through our suite of offerings and uncover tailored solutions designed just for you

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Risk Adjustment

Proven technology and services solutions for health care plans and organizations, including Medicare Advantage

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SOLUTION GROUPS

Retrospective Risk Adjustment Solutions

Improve reimbursement accuracy, optimize gap and chase, and streamline submissions

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Prospective Risk Adjustment Solutions

Proactively close gaps at the point of care and maintain compliance

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Solution finder

Discover what works best for you. Use our intuitive solution finder tool to navigate through our suite of offerings and uncover tailored solutions designed just for you

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Quality Improvement and Stars

Proven, tailored programs combined with strong industry expertise to help plans measure, analyze, and implement quality and Stars strategies with impact

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SOLUTION GROUPS

Stars Consulting Services

Pinpoint areas for improvement to maximize your Star potential

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Quality360™ HEDIS® Engine i-button

Manage Quality performance with an end-to-end solution

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

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Solution finder

Discover what works best for you. Use our intuitive solution finder tool to navigate through our suite of offerings and uncover tailored solutions designed just for you

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Advisory Services

Expert advisory services help optimize core health plan operations, reduce costs, enhance compliance, and drive improved member satisfaction and scalability.

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HIGHLIGHTS

Core Administration

Expert guidance that helps streamline core operations, lower costs, improve compliance, and enhance member satisfaction with scalable solutions.

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Risk Adjustment

Strategic services that optimize risk adjustment accuracy, ensure data integrity, and support revenue integrity and regulatory compliance.

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Solution finder

Discover what works best for you. Use our intuitive solution finder tool to navigate through our suite of offerings and uncover tailored solutions designed just for you

GET STARTED NOW
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Who we help

As market leaders with decades of domain experience, we engage with a diverse range of sector, from commercial, to private to government, across all lines of business

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Government-sponsored plans

Lower operating costs and improve outcomes with specialized solutions that meet regulatory requirements and member needs

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Commercial/Private plans

Improved efficiency and lower costs delivered through Core Administration, Risk Adjustment, Quality and Care Management Solutions

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Featured insights

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Press release

Clover Health announces business transformation initiatives to accelerate path to profitability

Industry Insights
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Whitepaper

Views on Value-Based Care

General

Resources

Insights

Perspectives, best practices, and innovation for health plans from our team of experts and around the industry

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Case studies

Real-world success stories and solutions

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Blogs & articles

Industry analyses, opinions, and trends

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Webinars

Online seminars for industry education

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Brochures

Detailed information on products and services

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Videos

Insights from leadership, solution info, promotional clips and product demos

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E-books

Digital guidebooks for payers

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Whitepapers

In-depth reports and informative research

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Knowledge hub

Simplifying complex information into easy-to-understand terms

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Featured insights

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Brochure

Accelerate improved diagnostic code identification and documentation

Risk Adjustment
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Blogs & articles

Efficient Ways to Improve Reimbursement Accuracy

Risk Adjustment
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Case study

Turning the Tide: A Health Plan’s Success Story Oversight Program Revitalizes Health Plan Facing Operational Challenges

Risk Adjustment

Podcast

Integrated ecosystem of best-in-class, scalable, turnkey solutions for health plans across all lines of business

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LATEST SEASON

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Season 3

Move from the burden of fragmented legacy systems to scalability

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PAST SEASONS

Season 2

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Season 1

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Latest episodes

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Podcast

S3E5

Achieving a Compliant Query Practice

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Podcast

S3E4

Tech Ecosystems: The New Operating Model

Newsroom

News and updates about UST HealthProof, the healthcare industry, events, and more

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News

UST HealthProof in the news and 
industry updates

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Events

Upcoming conferences and industry events

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Press releases

Official UST HealthProof announcements 
and updates

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Featured insights

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News

Safeguarding Sensitive Information: UST HealthProof’s Pledge on International Data Privacy Day

Information security
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Press release

UST HealthProof and HealthEdge Announce Multiyear Strategic Partnership with Gateway Health

General
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EXPLORE CAPABILITIES

BPaaS Ecosystem Core Administration Risk Adjustment Quality and Stars

POPULAR SEARCHES

search Care Management search Core Administration search BPaaS search Risk Adjustment search Industry Insights search Client Success Stories search Quality & Stars
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EXPLORE CAPABILITIES

BPaaS Ecosystem Core Administration Risk Adjustment Quality and Stars

POPULAR SEARCHES

search Care Management search Core Administration search BPaaS search Risk Adjustment search Industry Insights search Client Success Stories search Quality & Stars
Brochure

Reliable, Compliant, and Efficient Encounter Data Submissions

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Accuracy and compliance of submissions data can be a full-time job and keeping up to date on frequent regulatory changes while navigating multiple sources of submission data is a challenge that UST HealthProof’s platform and expert submissions team is ready to handle. We understand the complexities of Encounter Data Processing System (EDPS) submissions. Our solution ensures successful, compliant, and reliable data submissions to the Centers for Medicare & Medicaid Services (CMS), streamlining your operations and reducing the administrative burden. With our robust technology and expert-driven approach, we help health plans navigate regulatory challenges and maximize efficiency.


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Let us help unburden your plan

Helping you to focus on what matters the most – your members' care

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