ViPS, a General Dynamics Information Technology company, today announces its next-generation STARS Solutions suite, an advanced, comprehensive solution to assist health payers -- organizations liable for healthcare coverage for plan members or beneficiaries -- stop healthcare fraud, waste and abuse (FWA).
The software suite, comprising STARSSentinel(TM), STARSInformant(TM) and STARSCommander(TM), incorporates the industry's most integrated family of anti-fraud applications and an unparalleled level of detection, automation, in-depth investigative analysis, integrated workflow case management and return on investment (ROI).
"At General Dynamics Information Technology, we want to provide our health payer customers with relevant, cost-effective tools that they can use to reduce instances of healthcare fraud and support the federal government's efforts to generate savings," said Marcus Collier, senior vice president of General Dynamics Information Technology's Civilian/Homeland Security Solutions division. "STARSSentinel, STARSInformant( )and STARSCommander, either in concert or used separately, reflect 16 years of anti-fraud expertise and serve as powerful tools for health payers in decreasing FWA losses, increasing recoveries, developing provider educational programs and optimizing operational efficiencies."
A phased-in rollout for each component of the STARS suite of solutions is expected to begin in the first half of 2010. Purchase information is available upon request, and a preview of each solution will be featured at the General Dynamics Information Technology booth, No. 202, at the 2009 NHCAA Institute Anti-Fraud Expo, November 17-19 in Orlando, Fla.
STARSSentinel: Fraud and Abuse Lead Generation
STARSSentinel is an automated, early-warning detection application that enables health payers to screen health insurance claims to spot suspicious patterns. With its sophisticated rules-based logic, statistical algorithms and familiar web-based browser interfaces, the application pinpoints claims containing falsified procedure codes, services not rendered, upcoding, over-utilization and other common fraud tactics found across the full range of healthcare providers. Leads generated by STARSSentinel serve as a powerful starting point for initiating a fraud case, demanding back funds, creating provider educational programs or recommending claims editing improvements. The application's built-in business intelligence identifies potential instances of fraud and also shows the business impact in dollars for those events, substantiating measurable ROI. For more information on STARSSentinel, please visit: http://www.vips.com/documents/Insert_STARSol_STARSSentinel_ViPS_2pV3.pdf
STARSInformant: In-depth Investigative Analysis