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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 RiskRemedy?

RiskRemedy is an innovative AI-powered platform tailored for commercial property and casualty brokerages. Retail agencies, wholesale brokers, and risk consultants can effortlessly upload policies, carrier quotes, or renewal documents to receive polished, client-ready materials in mere minutes. This includes a comprehensive policy assessment that scrutinizes every endorsement while pinpointing exclusions and coverage gaps, a detailed side-by-side comparison of quotes, an in-depth renewal analysis that addresses specific forms and clauses, as well as a customized proposal that reflects the agency's unique branding. Each finding is meticulously linked to its original page, enabling producers to quickly verify the information provided. Teams utilize RiskRemedy to drastically minimize the time spent on analyzing expiring policies and crafting proposals, detect potentially damaging endorsements before they escalate into claims, and ensure that certificates of insurance align with contractual requirements. The platform is user-friendly, requiring no installation and featuring a low learning curve, empowering many teams to manage live client interactions from their first experience. Additionally, all uploaded documents are encrypted and are not used to enhance the AI, safeguarding client data, while every customer receives tailored support from commercial insurance experts. Consequently, RiskRemedy not only optimizes workflow processes but also significantly boosts the overall productivity of insurance brokerage operations, setting a new standard in efficiency within the industry.

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Integrations Supported

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Integrations Supported

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API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

Contact for pricing
Free Trial Offered?

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Web-Based Support

Customer Service / Support

Standard Support

Training Options

Documentation Hub
Webinars
Online Training

Training Options

Documentation Hub
Online 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

RiskRemedy, Inc.

Company Location

United States

Company Website

www.riskremedy.io

Categories and Features

AI Insurance

Not specified

Insurance

Not specified

Categories and Features

AI Insurance

Not specified

P&C Insurance

Not specified

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