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Average Ratings 0 Ratings

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ease
features
design
support

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Write a Review

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

Accelerate your due diligence processes and resolve issues more efficiently by utilizing investigative products that provide actionable insights into individuals, assets, and their connections. Enhance the speed of your investigations while improving your ability to find subjects, recover assets, and collect outstanding debts. Forge connections between people, properties, and enterprises by leveraging an extensive array of over 10,000 public and proprietary data sources that are refreshed daily, all supported by the TLOxp® platform. Utilize adaptable and user-friendly tools to link individuals with their assets and businesses effectively. Increase operational efficiency by revealing essential information even from incomplete data sets. Examine potential red flags, confirm claims, and pursue debt recovery using the latest intelligence available. Additionally, compile comprehensive information regarding individuals, businesses, and assets to assess and comprehend potential risks associated with your inquiries. By doing so, you can make informed decisions that mitigate risk and enhance your overall investigative capabilities.

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

Shift Technology

Founded

2013

Country

France

Website

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

Vendor Details

Company Name

TransUnion

Founded

1968

Country

United States

Website

www.transunion.com/solution/trulookup

Product Features

Product Features

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