Blogs & articles
Challenges and Opportunities in the Era of Interoperability
… reduce administrative burdens, and enhance overall care coordination for patients across the healthcare continuum. The CMS interoperability mandate includes: … advancements in healthcare analytics, population health management, and personalized medicine. The interconnected …
Press release
UST HealthProof’s Quality360™ Earns Certified Measures Status from NCQA
… a leader in core administrative services for U.S. healthcare payers, has proudly achieved Certified Measures™ status … highlights UST HealthProof’s dedication to elevating healthcare quality and efficiency, setting a new benchmark for excellence in healthcare management. “We’re proud to receive the benchmark for …
Blogs & articles
Mind the Gap: How to Close Gaps in Care—Fast
… but not in the current year. Timely closure of gaps in care—from health plans to providers and members—is critical to a successful healthcare system. “The quicker you can close the member gap, … provider network.” – Abe Chaya, Managing Director, Product Management How to Close Gaps in Care—Fast: Natural Language …
Solutions
Insitz Plus
… and performance … In today’s rapidly evolving healthcare landscape, data is the lifeblood of effective … plan leaders must navigate a complex ecosystem of cost management, quality improvement, and equitable care delivery. Insitz Plus is a leading-edge business …
Services
Risk Adjustment
… Trusted technology and services with solutions built for Medicare Advantage and other government healthcare businesses … Strong Risk Adjustment drives success for … and Quality Consulting … Comprehensive Risk Adjustment management that creates value … Explore our other …
Services
Core Administration
… your plan so you can focus on top line growth, outcomes and care for members … Welcome to our cloud-based payer … that powers our BPaaS ecosystem, our solutions help Medicare Advantage, Medicaid, Commercial, ACA and exchange plans … existing claims administration, Risk Adjustment, member management, and care management solutions … Handle a …
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Home Page
… business, we are singularly focused on unburdening health care. Through our best-in-class, scalable, ecosystem-based … expertise in Risk Adjustment, Quality Improvement and Stars management, we help improve efficiency while lowering your … BPaaS solution is a modern, integrated ecosystem of healthcare operations, processes, and solutions with scalability, …
Solutions
Quality360™ HEDIS Engine
… and data integration. It’s built to support end-to-end management of chart retrieval and data collection, gap … more than others in the market … Identify and prioritize care and quality gaps Attribute gaps to providers Integrated … trends and industry benchmarks, flexible sampling, chase management and integrated medical record review … Integrates …
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Who we help
… and Stars – all developed with the specialized needs of Medicare Advantage, Medicaid, Dual and SNP plans in mind … in Core Administration, Risk Adjustment, Quality and Care Management solutions … With a focus on lowering …