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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 Inaza?

Enhance the efficiency of your manual processes through intelligent document and image handling, enabling immediate underwriting and risk evaluation. Revolutionize your entire claims process from start to finish, incorporating real-time verification of documents and images, a powerful rules engine, timely notifications, and proactive communication strategies. With our state-of-the-art platform, you can easily implement extensive data pipelines for managing claims, conducting underwriting, enriching data, and utilizing telematics—all with a simple click. We redefine data-driven operations by ensuring straightforward access, providing valuable insights, and offering actionable measures derived from real-time data analysis. Our advanced AI technology streamlines processing, reducing manual workloads and ensuring faster, more accurate outcomes while helping to prevent fraud and erroneous information. By leveraging AI in document processing, our system significantly accelerates the underwriting workflow, reducing time-to-market and boosting overall productivity, which ultimately allows organizations to concentrate on strategic development. This innovative approach not only enhances operational effectiveness but also fosters a culture of continuous improvement and agility within organizations.

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

Inaza

Date Founded

2020

Company Location

Ireland

Company Website

www.inaza.com

Categories and Features

Categories and Features

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