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Description
DRILLER is an advanced analytics solution designed to facilitate the digitization and in-depth examination of insurance portfolios by processing both structured and unstructured data. It enhances the understanding of the portfolio's overall durability and the composition of claims. With its capabilities, it accelerates the release of reserves, contributing to reduced solvency capital needs and lower costs associated with capital. This innovative tool harnesses the power of artificial intelligence to conduct thorough analyses of portfolios and claims while forecasting the likelihood of adverse claim developments through a severity scoring system. Moreover, it allows for the early detection of claims that may be under or over-reserved. Users benefit from fully searchable documentation and claims, along with a comprehensive insight into portfolio composition. The tool excels in recognizing characters, numbers, and sentiment, categorizing documents, and pinpointing specific claim characteristics. Additionally, it streamlines the review and prioritization process for critical claims demanding immediate attention, all backed by an automated analysis of the entire portfolio, enhancing operational efficiency and decision-making.
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
DGTAL
Country
Germany
Website
dgtal.io/products/
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity
