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.
Get the solution sheet- 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
Shift Perspectives
Accurate fraud detection is the key to automated claims decisions.
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