Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
The product setup, policy design, underwriting, servicing, and claims management are all flexible and parameter-driven, eliminating the need for any IT programming. It accommodates both unit-linked and traditional product lines for individual and group business, managing the entire policy lifecycle from quotation right through to claims. Additionally, it features automated payment options such as direct credit, telegraphic transfer, or cheque printing for claims and commissions, complete with predefined authorization limits. A double-entry ledger is utilized for all financial transactions, providing detailed margin analysis and a standard automated interface to corporate ledgers. The system supports multiple languages, including Arabic, tailored to user or client preferences for both input screens and outgoing communications, including emails. Furthermore, clients and brokers can independently manage their services online, facilitating straight-through processing for new business. The workflow is enhanced by RAG-rated "to-do" lists for individual operators, allowing for comprehensive monitoring and task management. This creates an efficient ecosystem that not only streamlines operations but also improves user experience significantly.
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
FIT
Founded
1990
Country
United Kingdom
Website
www.fitltd.com
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity
Product Features
Insurance Policy
Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management