Average Ratings 0 Ratings

Total
ease
features
design
support

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

Write a Review

Average Ratings 0 Ratings

Total
ease
features
design
support

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

Write a Review

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

Screenshots View All

Screenshots View All

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

Product Features

Product Features

Alternatives

Alternatives

AgentC Reviews

AgentC

Celonis
Alaffia Reviews

Alaffia

Alaffia Health
Virtual Examiner Reviews

Virtual Examiner

PCG Software