Care Management
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The comprehensive Advisory Service tackles two critical areas simultaneously
Strategic Services That Drive Real Results
Expert Implementation That Makes the Difference
News
Last updated: Apr 28, 2025
UST HealthProof Unveils Advisory Service to Boost Performance
(April 28, 2025) - UST HealthProof launched a new Core Administration and Risk Adjustment Advisory Service designed to help health plans and risk-sharing providers improve coding accuracy, regulatory compliance, and financial performance.
“Health plans today face unprecedented challenges in optimizing their operations,” said Raj Sundar, co-founder and Chief Revenue & Strategy Officer. “Our advisory service doesn’t just identify problems – it delivers tailored solutions powered by AI that drive quicker, measurable results without disrupting daily operations.”
The comprehensive Advisory Service tackles two critical areas simultaneously:
Core administration services: assesses key operational functions across health plan macro processes, including enrollment management, claims processing, member and provider services and compliance and financial reporting. This leads to uncovering cost-saving opportunities and driving greater efficiency.
Risk adjustment services: enhances coding accuracy and completeness, optimizes risk score and reimbursement through HCC data reviews ensures alignment with evolving regulatory requirements.
“What makes this service unique is how we blend deep industry knowledge including emerging AI models with hands-on support,” Sundar explained. “We don’t just deliver recommendation and walk away. We partner with health plans to implement practical, actionable changes that deliver immediate and long-term value.”
Strategic Services That Drive Real Results
The Advisory Services portfolio includes specialized assessments designed to enhance performance while minimizing operational disruptions. Services include:
Operational Readiness Assessment: Ensures systems and processes are primed for optimal performance
Total Cost of Ownership (TCO) Analysis: Identifies hidden costs and inefficiencies
Implementation Health Check: Verifies systems are functioning and aligned.
Vendor Ecosystem Strategy: Optimizes integration across platforms for enhanced scalability.
Expert Implementation That Makes the Difference
UST HealthProof’s expert teams of certified coders, auditors, and healthcare consultants work directly with clients to develop a comprehensive understanding current practices and identify specific areas for improvement. This collaborative approach includes rigorous evaluation of both internal processes and vendor relationships that influence risk adjustment outcomes.
The service adapts to each organization’s unique structure and goals, providing ongoing guidance as regulations and systems evolve. By delivering insights into operational performance and system readiness, the advisory services support more informed decision-making and foster long-term stability for insurers navigating the increasingly complex healthcare administration landscape.
Transform your organization’s performance today. For more information on how our Advisory Service can benefit your organization, email inquiries@usthealthproof.com or visit our Knowledge Hub to learn more.
