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Preventing Healthcare Fraud, Waste and Abuse

Discover more about our program integrity products and services.

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General Dynamics Health Solutions

Preventing Healthcare Fraud, Waste and Abuse

It is estimated 3-10% of healthcare expenditures are fraudulent* – $90-100 billion – and less than one percent is recovered each year+. With a wide range of anti-fraud services and products, General Dynamics Health Solutions provides health payers with custom solutions to better manage anti-fraud programs and investigative costs, comply with regulatory requirements, augment staff expertise, and help detect and end Medicaid and Medicare fraud, waste and abuse.

Healthcare Fraud Prevention Services: Lead generation and assessment, insurance fraud investigation and support, clinical review services, claims verification services, training, consultative support and more.  

Demo - Fraud

STARSSolutions®: Designed with clinicians, claims and regulatory experts, administrators and data analysts, our STARSSolutions® software drives insight and analysis from complex data and monitoring modules to help track fraud, waste and abuse. Whether supporting our customers on-site or through a HITRUST managed cloud hosting environment, our tools include:

  • Pre-payment Analysis: STARSInterceptor® helps organizations anticipate and prevent fraud, waste and abuse by identifying aberrant utilization patterns, coding mismatch and billing-payment activities
  • Post-Payment Detection: STARSSentinel ® supports post-pay detection by examining utilization measures, financial profiles and high-impact fraud schemes to identify suspicious activity
  • Case and Workflow Management: STARSCommander® helps payers build, track and learn from caseloads to better capture, control and report program integrity data
  • Investigative Analysis: STARSInformant® supports advanced data mining and analytics to better assemble vast data and reporting outputs for strong exploration

Demo - Fraud

 *National Healthcare Anti-Fraud Association        +National Health Expenditure Fact Sheet

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Schedule a demo to learn how we can help your organization prevent healthcare fraud, waste and abuse.
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Join our webinar channel to learn the latest techniques for detecting and preventing fraud, waste and abuse across various provider specialties.
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Contact our program integrity experts to learn how we can help improve your efforts to fight fraud, waste and abuse.
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