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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 CEASE.ai?

A groundbreaking artificial intelligence system has been introduced to more effectively identify and address child sexual abuse material, with the goal of safeguarding victims more rapidly. By utilizing actual CSAM data, this AI adeptly scans, identifies, and flags new images that portray child exploitation with impressive accuracy. Collaborating with law enforcement agencies and leading Canadian universities, CEASE.ai harnesses a mix of neural networks and diverse AI models to ensure precise detection of such harmful material. The system provides investigators with an intuitive plugin that enables them to upload images from ongoing cases and utilize hash lists to exclude known content. Following this, the AI proposes possible labels and prioritizes images that could contain previously unrecognized CSAM. Investigators are then able to review the flagged images, confirm their illicit nature, bolster their cases against offenders, and hasten the rescue of at-risk victims. Moreover, social media platforms connect with the CEASE.ai API endpoint, allowing for the real-time processing of all user-uploaded images, which ensures that any content associated with child abuse is quickly identified and classified. This innovative methodology not only improves the efficiency of investigations but also plays a vital role in the ongoing effort to protect vulnerable children, ultimately contributing to a safer online environment for all.

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

2013

Company Location

France

Company Website

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

Company Facts

Organization Name

Two Hat

Date Founded

2012

Company Location

Canada

Company Website

www.twohat.com/cease-ai/

Categories and Features

Categories and Features

Content Moderation

Artificial Intelligence
Audio Moderation
Brand Moderation
Comment Moderation
Customizable Filters
Image Moderation
Moderation by Humans
Reporting / Analytics
Social Media Moderation
User-Generated Content (UGC) Moderation
Video Moderation

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