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What is eOxegen?

eOxegen represents a cutting-edge claims management solution that utilizes artificial intelligence to enhance the effectiveness of health insurance operations. By implementing a Straight Through Process (STP), the system significantly reduces the reliance on manual processes, leading to faster claim resolutions and improved accuracy. It incorporates advanced fraud detection mechanisms that employ AI algorithms to identify and flag suspicious activities early in the process. Additionally, eOxegen offers features such as provider contracting and empanelment, pre-authorization management, adjudication, and detailed reporting through business intelligence analytics dashboards. The automation of workflows driven by AI ensures that tasks are executed with consistency, decreases repetitive work, and enhances overall productivity. By combining these various capabilities, eOxegen empowers insurance companies and third-party administrators to optimize their claims management processes while simultaneously reducing operational expenses. As a result, this platform stands out as a revolutionary resource for the health insurance sector, promoting a more effective and trustworthy approach to claims handling. With its comprehensive set of tools, eOxegen not only streamlines operations but also positions its users to adapt to future challenges in the industry.

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

eOxegen

Date Founded

2002

Company Location

India

Company Website

eoxegen.com

Company Facts

Organization Name

Shift Technology

Date Founded

2013

Company Location

France

Company Website

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

Categories and Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Categories and Features

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