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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 LIFEfit?

The setup for products, policy crafting, underwriting, servicing, and claims handling is designed to be flexible and driven by parameters, which removes the necessity for any IT programming. It efficiently supports both unit-linked and traditional product offerings for individual and group businesses, overseeing the entire policy lifecycle from initial quotation to final claims processing. Moreover, it includes automated payment solutions such as direct credit, telegraphic transfers, or cheque printing for handling claims and commissions, all governed by predefined authorization limits. A double-entry ledger is implemented for every financial transaction, enabling thorough margin analysis and a standardized automated connection to corporate ledgers. The system is multilingual, accommodating languages like Arabic based on user or client preferences for input interfaces and outgoing communications, such as emails. Clients and brokers are empowered to manage their services online independently, which promotes seamless processing for new business. The workflow is further optimized by RAG-rated "to-do" lists assigned to individual operators, enhancing oversight and task management capabilities. This creates a highly efficient ecosystem that not only streamlines operations but also significantly elevates the overall user experience, making processes smoother and more transparent for all stakeholders involved. All of these features work together to establish a comprehensive solution that meets diverse business needs.

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

FIT

Date Founded

1990

Company Location

United Kingdom

Company Website

www.fitltd.com

Categories and Features

Categories and Features

Insurance Policy

Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management

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