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
Provide your advisors and policyholders with comprehensive, real-time guidance to help them select the most suitable coverage for their specific requirements. Utilize cutting-edge data to make a significant impact in the industry. Facilitate remote operations through intelligent applications. Enhance distribution and customer service to deliver unparalleled experiences for your clients. Equip your organization with new skills and knowledge across all business areas. Operate within our secure cloud environment or on-premises, ensuring enterprise-level data anonymization, traceability, and compliance with regulations such as IDD and GDPR. Effortlessly integrate with your existing systems through swift collaborations with partners like Salesforce, Microsoft 365, and Guidewire. From policy acquisition to claims management, implement and oversee essential AI-driven processes in real-time without sacrificing the integrity of fraud detection. This holistic approach not only enhances operational efficiency but also fosters a culture of innovation within the organization.
API Access
Has API
No
API Access
Has API
No
Integrations
Salesforce
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
Yes
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
Yes
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)
No
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
Zelros
Founded
2016
Country
France
Website
www.zelros.com
Product Features
Product Features
Insurance Agency Management
Claims Management
No
Commission Management
No
Contact Management
No
Document Management
No
Insurance Rating
No
Life & Health
No
Policy Management
No
Property & Casualty
No
Quote Management
No