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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 SOLIFE?

VERMEG has introduced SOLIFE, a comprehensive policy administration system tailored for providers in the life and health insurance sectors. This advanced platform simplifies the entire process of managing new business operations, policies, and claims, incorporating features like cash management, event tracking, and seamless integration with accounting systems, while also overseeing distribution and associated fees. It effectively manages reinsurance, adheres to tax and legal regulations, provides specialized reporting, and enables efficient claims processing. Drawing on over twenty years of industry knowledge, SOLIFE utilizes a customer-focused approach and undergoes regular updates to stay in line with changing regulatory frameworks, including MiFID and PRIIPs. The system is engineered for digital processing through APIs and a responsive design, ensuring that users experience a contemporary interface. Its high level of automation not only reduces administrative costs but also includes a flexible product design workbench that accelerates time-to-market for new offerings. Additionally, the system supports various distribution models, allowing it to adapt to diverse business needs, thereby maintaining its relevance in a dynamic market. This adaptability not only helps insurance firms enhance their operations but also equips them to effectively tackle their specific challenges in an evolving 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

Vermeg

Date Founded

1993

Company Location

Netherlands

Company Website

www.vermeg.com/product-solife/

Categories and Features

Categories and Features

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