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What is Shift Subrogation?

Shift Subrogation is an innovative software-as-a-service (SaaS) platform powered by artificial intelligence that independently identifies, assesses, and highlights potential subrogation recovery opportunities for insurance companies, particularly within the Property & Casualty (P&C) industry. By merging structured data such as policy details and claims with unstructured text, including loss descriptions and comments from adjusters, the system utilizes generative AI along with a range of analytical models to determine liability, apply relevant state laws and negligence principles, and examine exposures while factoring in statute limitations and jurisdictional regulations, as well as referencing external sources like product recalls. It generates alerts that come with scores and detailed explanations for each recovery opportunity, enabling claims handlers to grasp not only which cases are worth pursuing but also the rationale behind each suggestion. The platform also features continuous monitoring of claims, adapting alerts as new information emerges or as assessments of recoverability evolve over time. This ongoing vigilance helps insurance firms stay informed and take proactive steps in their recovery strategies, ultimately enhancing their operational efficiency in managing subrogation claims. Consequently, the integration of advanced technology ensures that these companies are equipped with the insights needed to maximize their recovery potential effectively.

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.

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/subrogation

Company Facts

Organization Name

Shift Technology

Date Founded

2013

Company Location

France

Company Website

www.shift-technology.com/products/payment-integrity

Categories and Features

Categories and Features

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