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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

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.

Description

Wyllo serves as a comprehensive risk intelligence platform tailored for the ecommerce sector, integrating identity, behavior, and post-purchase indicators throughout the entire customer experience, spanning from the initial purchase and checkout to returns, claims, and support services. Rather than assessing risk on a transaction-by-transaction basis, it consolidates customer insights within a dynamic decision-making framework that empowers teams with complete visibility into fraud and abuse across various brands and channels, while tracking the activities of individual users or groups across multiple orders and interactions. This innovative solution is crafted to enable merchants to make more assured, trust-driven choices without imposing unnecessary hurdles on legitimate customers. Its features encompass detection of bots and unauthorized resellers, AI-driven payment fraud screening supported by human fraud specialists, prevention of return fraud and abuse through sophisticated risk models, and the identification of risk and intent regarding claims and policy abuse before they escalate into refunds, disputes, or other complications. Additionally, Wyllo’s approach fosters a safer shopping environment by ensuring that genuine customers enjoy a seamless experience while efficiently mitigating risks.

API Access

Has API No 

API Access

Has API Yes 

Screenshots View All

Screenshots View All

Integrations

BigCommerce No 
Shopify No 

Integrations

BigCommerce Yes 
Shopify Yes 

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 No 
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 Yes 
Live Training (Online) Yes 
In Person No 

Types of Training

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

Vendor Details

Company Name

Shift Technology

Founded

2013

Country

France

Website

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

Vendor Details

Company Name

NoFraud

Founded

2014

Country

United States

Website

wyllo.ai/

Product Features

Product Features

Chargeback Management

Chargeback Dispute Management No 
Chargeback Insurance No 
Chargeback Prevention No 
Chargeback Recovery No 
For Banks / Issuers No 
For Merchants No 
For Suppliers / Manufacturers / Distributors No 
Fraud Detection No 
Reporting / Analytics No 

Fraud Detection

Access Security Management No 
Check Fraud Monitoring No 
Custom Fraud Parameters No 
For Banking No 
For Crypto No 
For Insurance Industry No 
For eCommerce No 
Internal Fraud Monitoring No 
Investigator Notes No 
Pattern Recognition No 
Transaction Approval No 

Alternatives

Shift Claims Reviews

Shift Claims

Shift Technology

Alternatives

FUGU Reviews

FUGU

FUGU Risk
Alaffia Reviews

Alaffia

Alaffia Health