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
STARSInformant( )is an advanced data analytical application that transforms the way health payers detect, investigate and pursue overpayments and fraud. Its powerful data analysis capabilities help validate real FWA activities to address loss identification and recovery. The STARSInformant software supports a full array of data inquiries and requirements including investigating fraud leads, filling data requests, studying emerging trends, researching the impact of revised medical policy, selecting providers/claims for audits and more. Its features, including its ad-hoc query engine, random sampling, statistical summaries, trending, provider outlier analysis, custom report creation and user-defined pattern recognition, enable health payers the ability to pursue all investigations. For more information on STARSInformant, please visit: http://www.vips.com/documents/Insert_STARSol_STARSInformant_ViPS_2pV3.pdf
STARSCommander: Comprehensive Case Management
STARSCommander is a sophisticated workload/case management tool that features enhanced web-based interfaces and functionality to increase efficiency, productivity, timeliness and reporting accuracy. Its customizable system supports all types of business processes required to safeguard against FWA, including fraud investigations, provider audits, medical reviews, policy studies, law enforcement data requests, provider educational programs and other initiatives. STARSCommander is a secure, fully electronic environment where health payers store the components of their cases/workload from start to finish: work plans, evidence, internal and external documents, claim details, final outcomes and more. Throughout the case development process, health payers can capture and prioritize their workload, track progress and report on caseload and recoveries. At every step the system maintains comprehensive audit trails. For more information on STARSCommander, please visit: http://www.vips.com/documents/Insert_STARSol_STARSCommander_ViPS_2pV3.pdf
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