Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Poetic is an advanced AI framework that assimilates knowledge similarly to other AI systems, yet it operates with the exactness characteristic of programming. Its purpose is to convert various inputs, including procedures, training resources, audio recordings, visual workflow representations, and historical case studies, into effective automation processes. Users have the ability to upload standard operating procedures, PDFs, training videos, and additional documentation related to processes, which Poetic then analyzes to generate an initial draft of an automated workflow. Following this, it enhances its outputs by integrating expert feedback, progressively refining its performance under the mentorship of the organization’s most skilled personnel until achieving a level suitable for production. For instance, when tasked with reviewing a dispute case, Poetic assesses card freeze and unfreeze events, articulates the outcome of the investigation, presents the evidence utilized, and incorporates suggestions to enhance its decision-making process. This includes broadening the review timeframe to identify more instances of first-party fraud, ultimately leading to improved accuracy and quality in decision-making. In this way, Poetic not only automates workflows but also evolves to meet the specific needs of the organization more effectively over time.
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
Poetic
Founded
2023
Country
United States
Website
poetic.com/product
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity