Optimizing Health Insurance Claims Processing & Fraud Detection with AI

Shift enables health insurers to prevent fraud, waste, and abuse prior to payment.

The healthcare industry has massive amounts of data available in health records, clinical trials, and in billing & claims processing systems. However, it’s still challenging for health insurers to unlock the value buried in this data to accelerate claim payments, reduce fraud, drive better patient outcomes, and maintain regulatory compliance.

Force Fraud Detection for Health

Force helps health insurers effectively identify potential fraud, waste, and abuse in the claims process. It’s an automated, AI-native, SaaS solution that works with your existing claims platforms.

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  • Force Enables Health Insurers to:
  • Identify more potential fraud, waste, and abuse cases
  • Reduce fraud losses and improper payments
  • Lower false positives and focus claims handler efforts
  • Improve investigator efficiency and shorten decision timeframes
  • Pay valid claims quickly, with confidence

Luke Claims Automation for Health

Luke is Shift’s AI claims automation solution. It enables health insurers to settle and pay a greater number of high-volume, low-touch claims quickly and confidently.

Get the Solution sheet
  • Luke Enables Health Insurers to:
  • Improve the claims experience
  • Settle and pay straightforward, valid claims more quickly
  • Increase claims handler productivity
  • Reduce claims leakage
  • Easily integrate automation with their existing claims platforms

Trusted by forward-thinking insurers globally.

Shift Perspectives

Fraud Awareness Week: The Many Faces of Fraud, Waste and Abuse

November 20, 2019

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Defeating fraud: the key to automating claims with confidence

November 19, 2019

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International Fraud Awareness Week: New Solutions for an Old Problem

November 18, 2019

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Tear Down The Walls: Liberating Siloed Data to Drive Innovation

November 11, 2019

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Accurate fraud detection is the key to automated claims decisions.

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