30 Years of Experience Helping Payers Deter Fraud and Measure Quality
Through a portfolio of value add products and services, General Dynamics Health Solutions enables payers to achieve strategic objectives in improving the quality of care and managing costs. Our health experts understand the challenges payers are experiencing with maintaining strong provider networks and delivering results to meet regulatory demands.
Our solutions pair robust technology with a deep understanding of the regulatory landscape, data analysis, healthcare billing, claims processing and fraud, waste and abuse schemes. With a team of clinicians, investigative claims experts, administrators, data analysts and regulatory experts, we develop customized solutions that meet organizational needs and requirements – enabling payers to focus on quality healthcare and better outcomes.
Our commercially available suite of solutions, STARSSolutions and SourceMeasures, provide healthcare payers with tailored solutions that protect against fraudulent activities while measuring and reporting quality.
Our industry-leading suite of STARSSolutions products and services provide public and private payers with tailored solutions that protect against fraudulent activities, prevent inappropriate payments and aid in recoveries. Our solutions include:
- STARSInterceptor® – pre-payment analysis
- STARSSentinel® – post-payment detection
- STARSCommander® – case and workflow management
- STARSInformant® – investigative analysis
SourceMeasures, a National Committee for Quality Assurance (NCQA)-certified HEDIS solution suite, provides a single source for measurement, reporting and improvement for Healthcare Effectiveness Data and Information Set (HEDIS), Quality Rating System (QRS) and state measures. Our solutions include:
- Administrative and hybrid measure components
- NCQA, CMS and state submission tools
- Medical record review and quality improvement services