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What is Shift Payment Integrity?

Shift’s Payment Integrity presents a sophisticated AI-enhanced solution specifically designed for health plans, focusing on improving accuracy while reducing costs in the claims payment process. This cutting-edge tool functions effectively in both the pre-payment and post-payment stages, allowing plan administrators to detect potential problems early and recover overpayments with ease. Key features include dynamic claims editing with up-to-date rules, AI-assisted examinations of medical records, identification of anomalies, as well as fraud, waste, and abuse, along with the incorporation of external data for a more thorough analysis. The system is built to adapt to evolving policies and guidelines, featuring automated policy evaluations and an edit logic workbench that permits health plans to test ideas before full implementation. Furthermore, it offers clear flags and alerts that inform reviewers of the reasons behind claim flagging, speeds up document reviews by highlighting crucial sections of records, and uses data mining techniques to reveal emerging patterns. In addition, the platform provides a unified case management interface that optimizes investigative workflows, driving greater operational efficiency for health plans. Ultimately, this innovative solution empowers health plans to navigate the complexities of the claims process more effectively.

What is ALFRED Claims Automation?

Filing claims is often a complex yet vital task that many people, more than 60%, choose to avoid due to its convoluted nature and the significant time it demands. Artivatic has developed a tailored claims platform that addresses the needs of various insurance sectors, allowing companies to provide a seamless digital claims experience, facilitate self-processing, automate assessments, and improve the detection of risks and fraud while also managing claims payments. This innovative platform is designed to meet all your claims-related needs, delivering a fully automated and thorough evaluation process. Whether you're dealing with auto, health, travel, accidental, death, fire, SME, business, or commercial claims, this solution ensures comprehensive coverage. By simplifying the claims mechanism, Artivatic seeks to boost operational efficiency and enhance overall customer satisfaction, paving the way for a more user-friendly experience in the insurance landscape. With such advancements, the future of claims processing looks significantly brighter.

Media

Media

Integrations Supported

Integrations Supported

Amazon Web Services (AWS)
Apache Cassandra
Google Cloud Platform
IBM Cloud
Microsoft 365
Microsoft Azure
Microsoft Dynamics 365
Oracle Cloud Infrastructure
Oracle Database
PostgreSQL

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

$10/claims/month
One time installation and customization

Supported Platforms

SaaS

Supported Platforms

SaaS
Android
Windows
Mac
Linux

Customer Service / Support

Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Shift Technology

Date Founded

2013

Company Location

France

Company Website

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

Company Facts

Organization Name

Artivatic.ai

Date Founded

2017

Company Location

India

Company Website

alfred.artivatic.ai/

Categories and Features

AI Insurance

Not specified

Insurance

Not specified

Categories and Features

AI Insurance

Not specified

Claims Processing

Not specified

Health Insurance

Not specified

Insurance Claims Management

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

Insurance Policy

Not specified

Life Insurance

Not specified

P&C Insurance

Not specified

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