
Maximize savings, minimize errors with AI-driven payment accuracy for health plans
AI-powered edits, optimized scenarios, accelerated workflows. Take control of your payment integrity at critical steps of the healthcare claims process
Catch issues before they cost you
Shift payment integrity delivers AI-driven accuracy at key points in the claims process—analyzing policy, provider behavior, and records to prevent costly errors and identify emerging schemes. Shift empowers health plans to act quickly and precisely, boosting prepay savings and postpay recoveries.

Go beyond generic or outdated edits that leave savings opportunities on the table with a tailored approach and trusted AI that helps plans prevent more loss
Up-to-date content
Any-pass deployment
Policy-driven edits

Use generative AI to quickly highlight areas within medical records in need of further review—accelerating the process for review teams and generating insights faster
Generative AI analysis
Accelerate workflows
Explainable detail

Analyze plan data to uncover anomalous activity, emerging trends, and patterns
Continually optimized concepts
Enriched data
Transparent analysis

Stay ahead of emerging schemes and identify high-value alerts with powerful AI-driven scenarios and integrated case management tools
360° view
Powerful AI
Network detection
Powerful detection across the Payment Integrity lifecycle
Shift’s payment integrity solution breaks out of the confines of static, rules-based detection methods with continuous learning, evolving schemes - capturing evolving FWA and high-value cases while automatically providing investigators with the details and data they need to accelerate post-pay investigations.
Accelerating Payment Integrity with Generative AI
As the care delivery, policy and payment landscape evolves, payment integrity innovation must keep up. Learn how modern tools such as generative AI can help teams take on the challenges in the wake of policy or care delivery changes, medical record and other document review, and reducing provider abrasion with fast, accurate analysis of claims.

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Learn how Shift can help you strengthen your plan’s payment integrity.