Average Ratings 0 Ratings
Average Ratings 0 Ratings
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
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