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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

An automated claims platform that operates seamlessly from start to finish, leveraging AI-driven decision models for tasks such as data collection, policy and coverage verification, medical coding, and consistency assessments. Our advanced AI models are designed to minimize losses and enhance your loss ratios by effectively detecting fraud, waste, and abuse in health and life insurance sectors. Qantev empowers insurers globally by improving operational efficiency, curbing losses, and elevating client satisfaction. By integrating artificial intelligence with deep medical knowledge, our dedicated team of data scientists and engineers has created cutting-edge solutions that streamline the claims management process while identifying fraudulent activities. Our specialized AI tools are adept at capturing, cleansing, enhancing, and digitizing data from a variety of claims documents in multiple languages. Additionally, we bolster the performance of your medical provider network with automated insights, identifying pricing gaps, recommending strategies, simulating different scenarios, and much more to optimize outcomes. This holistic approach ensures that insurers not only respond to claims effectively but also proactively prevent potential issues before they arise.

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 No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

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

Qantev

Founded

2018

Country

France

Website

www.qantev.com

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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