Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
ClaimVision is AI claims intelligence for US property insurers. It reads the whole claim file and policy and cites every finding to clause and page. It checks coverage, flags missing items and subrogation opportunities, and leaves the decision with your adjusters. Runs on Microsoft Azure.
Description
Shift’s Payment Integrity offers an advanced AI-driven solution tailored for health plans, aimed at enhancing the precision and minimizing expenses involved in the claims payment process. This innovative tool operates effectively during both pre-payment and post-payment phases, enabling plan administrators to identify potential issues early on while also recovering overpayments efficiently. Among its notable features are dynamic claims editing with updated rules, AI-supported reviews of medical records, detection of anomalies as well as instances of fraud, waste, and abuse, and integration of external data for a more comprehensive analysis. The system is designed to adapt to changing policies and guidelines, featuring automated policy assessments and an edit logic workbench that allows health plans to experiment with concepts prior to implementation. It also includes clear flags and alerts that inform reviewers about the reasons behind claim flagging, facilitates faster document reviews by emphasizing key sections of records, and employs data mining techniques to uncover emerging trends. Additionally, the platform boasts a cohesive case management interface that streamlines investigative workflows, further enhancing operational efficiency for health plans.
API Access
Has API
No
API Access
Has API
No
Integrations
Duck Creek Claims
Yes
Guidewire ClaimCenter
Yes
Sapiens ClaimsPro
Yes
Integrations
Duck Creek Claims
No
Guidewire ClaimCenter
No
Sapiens ClaimsPro
No
Pricing Details
Pricing is based on claim volume and scope, with terms determined for each pilot.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
No
Vendor Details
Company Name
Decision Agency OÜ
Founded
2025
Country
Estonia
Website
claimvision.ai
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity
Product Features
Insurance Claims Management
CRM
No
Claims tracking
No
Customer portal
No
Document management
Yes
EDI data exchange integrations
No
Electronic claims
No
Fraud management
No
Reporting
Yes