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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 Daisy Intelligence?

Daisy is an innovative AI software firm that specializes in providing explainable Decisions-as-a-Service for sectors such as retail merchandise planning and insurance risk assessment. Its advanced AI platform operates fully autonomously, eliminating the need for coding, infrastructure, or inherent biases, which empowers your team to focus on core objectives, enhance customer service, and drive shareholder value. In the retail sector, Daisy's system facilitates optimal promotional item selection, dynamic pricing strategies for both regular and promotional prices, enhanced demand forecasting, strategic inventory distribution, and refined assortment planning. For insurance clients, the Daisy system is adept at identifying and mitigating fraudulent claims while streamlining claims automation, thereby reducing the necessity for human intervention in the claims process. Furthermore, Daisy's solutions are designed to deliver verifiable financial outcomes, guaranteeing a minimum net income return of 10X, making it a valuable asset for businesses seeking to maximize their profitability and efficiency. This dual capability in retail and insurance positions Daisy as a leader in the AI-driven decision-making landscape.

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

Daisy Intelligence

Date Founded

2003

Company Location

Canada

Company Website

www.daisyintelligence.com

Categories and Features

Categories and Features

Sales Forecasting

Competitor Analysis
Correlation Analysis
Dashboard
Dynamic Modeling
Exception Reporting
Graphical Data Presentation
Modeling & Simulation
Performance Metrics
Sales Trend Analysis
Statistical Analysis

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