UST Global has oriented its services around the following major platforms to offer our services in a Business Platform-as-a-Service (BPaaS) model while continuing to support enterprise-class customers with more traditional IT and BPO services.
Our platforms and services are designed to the highest standards of security, confidentiality and compliance. In addition, our integrated approach generates the best possible outcomes for patients and providers by synergistically aligning the wisdom, empathy and insight of human agency with deep digital capabilities.
Our enterprise solution detects payment error issues such as fraud, waste and abuse (FWA) using a prospective and retrospective self-learning platform supported by certified clinicians around the globe
Our revenue integrity platform correlates prevalence of diagnosis codes against norms derived from clinical and medical graph repositories, 60+ million patient records and 38,000+ physicians hours – empowering healthcare payers to maximize revenue from risk adjustment programs
Benefit from a utilization, disease and care management platform that leverages health risk assessment and prevention as well as device-based home monitoring to drive coordinated evidence-based interventions
Out of the over $750 billion in annual fraud, waste and abuse, just five types of waste consume an estimated one third of the total amount: care coordination failures, administrative complexity, overtreatment (10-20% of surgeries are unnecessary), care delivery failure and pricing failures. An intelligent learning system, rather than a library system, is key to identifying fraud during the introduction of new drugs and services.
Constantly changing payment innovation models and an increasing focus on accurate coding and verifiable risk assignment demand a very agile and extensible revenue integrity platform. By 2019, providers could see a 50% increase in the amount of revenue that requires collection from patients. Of that amount, 30% (as much as $200 billion) may be written off as uncollectable; thus, a platform which can identify risk at the point of service is crucial.
Inadequate care coordination is estimated to cause between $25 and $45 billion in wasteful spending due to avoidable complications and unnecessary hospital readmissions, thus making a state-of-the-art, technology-enabled care management solution essential to sustainable delivery of healthcare services.
UST Global has been a trusted partner to premier healthcare organizations for over fifteen years. Today, we offer a broad range of solutions, each with end-to-end design execution and production services. Our expertise includes digital health, operational transformation, consumer-centric innovations and assisting providers with the transition from volume-based to value-based health solutions.
Focus on the Customer
- Defining 360° member needs for retail enablement
- Consumer focused digital transformation, mobile and social strategies
- Early prediction analytics to prevent provider and member abrasion
- Use of AI and IA to create personalized health communication and behavioral change strategies
- Strategies to avoid overpayment and FWA
- Integrated health management and clinical data exchange strategies
- Best-in-class quality improvement strategies
- Ensuring revenue integrity, coding auditing and risk adjustment strategies
- Improving operational efficiency in EDI, claims, encounters, enrollment and care management
- Assisting organizations in creating a continuous innovation environment
- Support CROs, pharmaceutical and medical device organizations for advanced data analytics including unstructured data
In addition to BPaaS, we offer the following business process services:
- Healthcare interoperability
- Pharmacy solutions
- Provider payer collaboration
- Enrollment and benefits
- Sales and marketing solutions
- Human-centered design and digital transformation (mobile/social/augmented reality)
- Cybersecurity in healthcare
- Use of cutting edge technologies like blockchains
- Data interoperability across unstructured data, structured claims and clinical data for a true 360 degree patient view
- Customer-centric transformation including legacy modernization
- Supporting mergers and system consolidation
- Telemedicine and e-discharge solutions