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What is Shift Claims Fraud?

Shift Technology’s Claims Fraud platform revolutionizes insurance fraud detection by combining AI, data integration, and investigative tools into one solution. Designed specifically for insurers, it identifies fraudulent claims at first notice of loss (FNOL) and throughout the claims lifecycle, enabling carriers to act before damage escalates. Its advanced AI models continuously learn from millions of claims and cross-carrier data, uncovering hidden patterns and sophisticated fraud rings. With the Insurance Data Network, insurers benefit from industry-wide intelligence, gaining the ability to connect dots between people, providers, and claims in real time. This reduces false positives and ensures investigators focus on the highest-impact cases, ultimately accelerating resolution. Shift also integrates external data sources and offers eForm, workflow, and reporting features to enhance operational efficiency. Trusted by over 115 insurers, it has detected 13M+ suspicious claims and helped identify billions in fraudulent payouts. Global carriers like AXA, Assurant, and L’olivier report measurable benefits, from millions saved to improved fraud prosecution outcomes. Recognized by Celent as a luminary in fraud detection, Shift stands at the forefront of insurance technology innovation. By blending scale, speed, and intelligence, it equips claims teams, SIUs, and executives with a powerful weapon against fraud.

What is Qantev?

An automated claims management system that functions smoothly from beginning to end, utilizing AI-based decision frameworks for various tasks including data gathering, verification of policies and coverage details, medical coding, and evaluations of consistency. Our sophisticated AI frameworks aim to reduce losses and improve your loss ratios by proficiently identifying instances of fraud, waste, and abuse in both health and life insurance domains. Qantev supports insurance providers worldwide by enhancing operational efficiency, reducing losses, and boosting customer satisfaction. By fusing artificial intelligence with extensive medical expertise, our committed group of data scientists and engineers has developed innovative solutions that optimize the claims management process while uncovering fraudulent activities. Our specialized AI tools excel at capturing, cleaning, enhancing, and digitizing information from a wide range of claims documents in various languages. Furthermore, we enhance the efficacy of your medical provider network through automated insights, pinpointing pricing disparities, suggesting strategies, simulating various scenarios, and much more to improve outcomes. This comprehensive strategy guarantees that insurers not only handle claims efficiently but also proactively mitigate potential challenges before they emerge, ensuring a robust insurance framework. Ultimately, our dedication to innovation drives the future of claims processing, setting new standards for excellence in the industry.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Shift Technology

Date Founded

2014

Company Location

France

Company Website

www.shift-technology.com/products/claims-fraud

Company Facts

Organization Name

Qantev

Date Founded

2018

Company Location

France

Company Website

www.qantev.com

Categories and Features

Fraud Detection

Access Security Management
Check Fraud Monitoring
Custom Fraud Parameters
For Banking
For Crypto
For Insurance Industry
For eCommerce
Internal Fraud Monitoring
Investigator Notes
Pattern Recognition
Transaction Approval

Categories and Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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