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Average Ratings 0 Ratings

Total
ease
features
design
support

No User Reviews. Be the first to provide a review:

Write a Review

Description

Introducing the revolutionary insurance claim automation system, which is enhanced by innovative blockchain technology. The claims process represents a critical juncture for insurance providers, and our solution is meticulously engineered to streamline claims for both policyholders and insurers, ensuring unparalleled precision and rapid processing—from pre-claim assessments to final payment settlements. MediConCen stands at the forefront of insurance technology, leveraging Hyperledger Fabric blockchain to transform the claims landscape for insurance firms, medical networks, and healthcare facilities. Our platform equips claims adjusters with sophisticated AI algorithms and advanced decision-making tools to swiftly identify fraudulent activities while allowing legitimate claims to be processed without delay, ensuring optimal management of claim costs and remarkable operational efficiency. Additionally, we provide insightful analytics that enhance underwriting processes and drive product innovation, empowering stakeholders with the information they need to succeed in a competitive marketplace. This comprehensive approach not only simplifies the claims experience but also fosters trust and reliability in the insurance industry.

Description

Shift’s Payment Integrity offers an advanced AI-driven solution tailored for health plans, aimed at enhancing the precision and minimizing expenses involved in the claims payment process. This innovative tool operates effectively during both pre-payment and post-payment phases, enabling plan administrators to identify potential issues early on while also recovering overpayments efficiently. Among its notable features are dynamic claims editing with updated rules, AI-supported reviews of medical records, detection of anomalies as well as instances of fraud, waste, and abuse, and integration of external data for a more comprehensive analysis. The system is designed to adapt to changing policies and guidelines, featuring automated policy assessments and an edit logic workbench that allows health plans to experiment with concepts prior to implementation. It also includes clear flags and alerts that inform reviewers about the reasons behind claim flagging, facilitates faster document reviews by emphasizing key sections of records, and employs data mining techniques to uncover emerging trends. Additionally, the platform boasts a cohesive case management interface that streamlines investigative workflows, further enhancing operational efficiency for health plans.

API Access

Has API Yes 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Hyperledger Fabric Yes 
WhatsApp Yes 

Integrations

Hyperledger Fabric No 
WhatsApp No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person Yes 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person No 

Vendor Details

Company Name

MediConCen

Country

China

Website

www.mediconcen.com.hk/

Vendor Details

Company Name

Shift Technology

Founded

2013

Country

France

Website

www.shift-technology.com/products/payment-integrity

Product Features

Insurance Claims Management

CRM No 
Claims tracking No 
Customer portal No 
Document management No 
EDI data exchange integrations No 
Electronic claims No 
Fraud management No 
Reporting No 

Product Features

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