Average Ratings 0 Ratings
Average Ratings 0 Ratings
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
Integrations
BigCommerce
No
Shopify
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
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