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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

Openkoda is a specialized application development platform tailored specifically for the insurance industry. It enables carriers, insurtech companies, managing general agents (MGAs), startups, and service providers to efficiently create comprehensive web applications, APIs, and internal tools much quicker than traditional development methods allow, while also ensuring that teams maintain complete control over their source code. Built on an open-source framework, the platform eliminates the risk of vendor lock-in. With a modular architecture and pre-existing templates, Openkoda speeds up essential insurance processes such as policy issuance, claims handling, endorsements, and renewals, all within containerized environments that can scale horizontally and do not impose per-user fees. Additionally, Openkoda comes equipped with industry-specific accelerators, including an AI-capable policy administration core, claims management workbenches, embedded insurance checkout components, and dashboards for underwriters that can access external risk information or activate machine learning models. This robust functionality positions Openkoda as a powerful asset for any organization looking to innovate within the insurance landscape.

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

Basecamp
Discord
GitHub
Jira
LDAP
Microsoft Teams
Slack
Stripe
Trello

Integrations

Basecamp
Discord
GitHub
Jira
LDAP
Microsoft Teams
Slack
Stripe
Trello

Pricing Details

$4000/month
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

Openkoda

Founded

2022

Country

Poland

Website

openkoda.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

Insurance Policy

Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management

Insurance Underwriting and Rating

Broker / Agent Portal
Carrier Upload
Commercial Lines
Comparative Insurance Rating
Customer Portal
For Casualty Insurance
For Health / Medical Insurance
For Life Insurance
For Personal Insurance
Multi-State
Multiple Line Rating

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