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Description
Facio delivers AI-driven software infrastructure tailored for specialty insurance entities, including Managing General Agents (MGAs). Our innovative platform, FacioMGA, caters to the entire policy lifecycle, encompassing submission intake, risk classification, underwriting, quoting, binding, policy issuance, endorsements, billing, commissions, compliance, reporting, renewals, and integrations. Clients can customize products, rating rules, eligibility standards, workflows, documents, and permissions without the need to overhaul technology for each individual program. Additionally, Facio provides independent solutions for surplus-lines tax and fee computation, SIC/NAICS classification, sanctions screening, actuarial tasks, and automated workflows for carrier declinations. Our Org2vec technology establishes a memory backed by evidence, linking policies, contracts, financial records, assets, suppliers, cybersecurity frameworks, and operational data. Meanwhile, Facio Eigen introduces a zero-trust control framework that enforces permissions, rules, approvals, and audit trails for AI-enhanced decisions and actions. By leveraging these advanced technologies, we empower organizations to streamline their operations and enhance compliance.
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
No images available
Integrations
No details available.
Integrations
No details available.
Pricing Details
$65/mo./user + cloud
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
Facio
Founded
1600
Country
United States
Website
www.facio.io
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity