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Average Ratings 0 Ratings

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ease
features
design
support

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Description

CoverSelf has developed an advanced, cloud-native claims accuracy platform tailored specifically for the healthcare sector, utilizing cutting-edge software development practices. This innovative solution supports users in achieving sustained success by adapting seamlessly to the continual changes in claims and payment inaccuracies, thereby minimizing challenges and administrative expenses. By allowing open collaboration among all partners focused on tackling claims discrepancies and operational inefficiencies, the platform enables faster customization, innovation, and deployment. Additionally, CoverSelf’s payment integrity system leverages contemporary technologies to resolve payment leaks and inaccuracies while maintaining a high level of transparency and accessibility for payers. The platform fosters the creation of novel scenarios and data mining algorithms, driving product innovation and accelerating customization efforts, all within a specialized framework that enhances the speed of innovation. Furthermore, it automates the correction and processing of claims, eliminating the need for further human intervention or effort, thus streamlining operations even more efficiently. This comprehensive approach not only optimizes the claims process but also significantly contributes to improving overall healthcare operations.

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

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

CoverSelf

Country

United States

Website

www.coverself.com

Vendor Details

Company Name

Shift Technology

Founded

2013

Country

France

Website

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

Product Features

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