Average Ratings 0 Ratings
Average Ratings 0 Ratings
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.
Description
Smart Automation significantly boosts user productivity when it comes to servicing clients. By reducing the need for manual intervention, it ensures a better experience for both users and customers alike. Annual system costs should not be tied to your business's performance; instead, we align these costs with the services we deliver to you. Our system allows for comprehensive management of the entire policy lifecycle, covering transactions such as rating, validation, quoting, binding, issuance, and policy modifications. It includes a robust double-entry accounting framework to oversee all financial transactions related to policies and claims. Real-time policy coverage verification is an available feature, enabling efficient management of reserves, loss payments, and expenses at a granular claims level. Policyholders have the ability to confirm their coverage, print policy documents, check the status of claims, review their accounts, and process payments. The application comes equipped with numerous pre-built interfaces, including Payment Gateway, Replacement Cost Valuation, Insurance Credit Scores, Motor Vehicle Records, and eSignatures. Additionally, a mobile app is provided to facilitate easy access for field adjusters, allowing them to quickly upload assessments and photos directly into the claims system, thereby streamlining the claims process further. This integration of technology not only simplifies operations but also enhances communication and efficiency across the board.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
Yes
iPad App
Yes
Android App
Yes
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
No
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
Shift Technology
Founded
2013
Country
France
Website
www.shift-technology.com/products/payment-integrity
Vendor Details
Company Name
SimpleSolve
Country
United States
Website
www.simplesolve.com
Product Features
Product Features
Insurance Agency Management
Claims Management
Yes
Commission Management
Yes
Contact Management
No
Document Management
No
Insurance Rating
No
Life & Health
Yes
Policy Management
Yes
Property & Casualty
Yes
Quote Management
No