New HCC Management Solution Suite From DST Health Solutions Targets Growing Medicare Advantage Plans & Health Insurance Marketplace

'HCC Revenue Cycle Management Services' Built To Simplify and Control Payer Revenue Management Process

Aug 15, 2013, 10:03 ET from DST Health Solutions, LLC

BIRMINGHAM, Ala., Aug. 15, 2013 /PRNewswire/ -- DST Health Solutions, LLC (DSTHS), a leading provider of technology solutions and services to health plans, integrated delivery systems, and health care providers, today unveiled its HCC Revenue Cycle Management Services, a state-of-the-art platform designed to serve the expanding government-sponsored insurance market.

The new HCC RCM solution, an addition to DSTHS' existing government-sponsored insurance portfolio, was specifically designed to provide health plans and Accountable Care Organizations (ACOs) with an enhanced ability to manage reimbursement levels. The ability to obtain accurate revenue for associated risk ultimately impacts the quality of benefit offerings and member care.

The need to perform revenue analysis and correction is becoming more prevalent due to the expansion of government-sponsored individual programs. According to Teri Mullaney, Chief Strategy Officer for DST Health Solutions, HCC RCM represents a better choice for providers to drive accurate reimbursement, provide financial insight, and support the closure of care gaps.

"To date, the payer revenue management industry has been fraught with issues, mainly associated with the disparate systems used to support the process," says Mullaney. "Using an enterprise-level business process management system like HCC Revenue Cycle Management Services will provide unparalleled simplification, transparency, and control to this process." 

The HCC RCM technology platform includes three distinct functional components: 

  • A population health analytic system based upon client-controlled preferences to stratify target populations in order to identify care and HCC gaps, medication non-adherence, and other clinical indicators, providing necessary insight to determine the best retrospective/prospective program mix
  • A Business Process Management (BPM) based upon user-defined workflows, queues, and use rules, coupled with DSTHS' unique probability based algorithms, to seamlessly automate and evaluate the medical record abstraction process, easily identifying and correcting abstraction errors
  • 3i technology to provide real-time project status and outcomes-based reporting, with project data and event alerts on an aggregate, cohort, or drill-down basis.

For retrospective analyses, DSTHS utilizes its clinical abstraction team to extract all diagnoses from the medical record and in-home assessments to ensure revenue accuracy and support population health initiatives.   

"Combined with our team of full-time clinical coding professionals, medical economists, and industry experts, this technology ensures more accurate revenue," says Mullaney.  "More than that, HCC RCM provides a unified platform to drive more focused population health initiatives."

The HCC RCM solution is supported by DSTHS' team of medical economists, clinical review experts, and data and process analysts. Users can also take advantage of DSTHS' RAPS/EDPS and EDGE Server solutions to provide the necessary data to CMS for Medicare Advantage and the Marketplace population.

About DST Health Solutions
DST Health Solutions, LLC, a wholly-owned subsidiary of DST Systems, Inc., delivers systems and services that help improve efficiency, reduce operational costs, increase speed to market, and facilitate medical cost management and price containment. Clients include commercial health plans, consumer-directed plans, government plans (Medicare Advantage, Medicare Part D and Medicaid) and physician practices. DST Health Solutions' enterprise applications and outsourcing services include claims processing, member and provider management, benefit plan management, new product development, care management and medical management, and decision support/analytics. For more information about DST Health Solutions, contact 800.272.4799, e-mail, or visit

Laura M. Parsons
DST Public Relations

SOURCE DST Health Solutions, LLC