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Average Ratings 0 Ratings

Total
ease
features
design
support

No User Reviews. Be the first to provide a review:

Write a Review

Description

Our data prediction system is powered by a sophisticated artificial intelligence framework that utilizes exclusive algorithms and machine learning techniques to detect and forecast potential risks associated with significant losses, extensive litigation, and other financial burdens. By harnessing machine learning alongside statistical modeling approaches, we analyze client data and complement it with external sources to enable the AI to accurately assess risk. Our comprehensive product offerings can function independently or be seamlessly integrated into existing business intelligence platforms like Board, Tableau, or Microsoft BI. Whether it's managing worker’s compensation claims or processing general liability issues, our solutions can align with your insurance provider, third-party administrator, or your internal systems if you are self-insured. By utilizing our services, you can mitigate your risk through precise and thorough defense documentation, diminished settlement expenses, expedited resolutions, and proactive measures aimed at risk reduction. We also offer tools for predicting costs associated with general liability or worker’s compensation claims, facilitating swift settlements and providing more precise premium calculations, ultimately enhancing your operational efficiency in risk management. Our commitment is to deliver innovative solutions that not only meet but exceed your risk management needs.

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

Board
Microsoft Power BI
Tableau

Integrations

Board
Microsoft Power BI
Tableau

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

Mobotory

Country

United States

Website

mobotory.com

Vendor Details

Company Name

Shift Technology

Founded

2013

Country

France

Website

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

Product Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Product Features

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