Skip to content
EN-US 
Payment Integrity

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

Download the data sheet  

 

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.

Claims editing
Claims editing Accelerated medical record review Data mining FWA detection
files-lightBG_Trail and Error
Claims editing
 files-lightBG_Health Report
Accelerated medical record review
 files-lightBG_Abacus
Data mining
 files-lightBG_Fraud Detection
FWA detection
files-lightBG_Trail and Error

Go beyond generic or outdated edits that leave savings opportunities on the table with a tailored approach and trusted AI that helps plans prevent more loss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

Keep a pulse on policy and plan guidelines with automatic updates of code sets and industry releases.

Any-pass deployment

Policy-driven edits

Powerful detection across the Payment Integrity lifecycle

Pre Payment
Pre Payment Post Payment
Pre Payment
Post Payment
Shift’s payment integrity solution enables lightning-fast detection and decisioning before a claim is paid. Shift's AI-powered claims editing and prepay FWA detection stops improper payments and emerging schemes in their tracks. Combined with enhanced external data, teams are equipped with the context behind the decision or alert to quickly conduct investigations and reduce provider abrasion.

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.

Download Now  
240610-H&L-smartbrief-acceleratingPaymentIntegrity

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

 

Schedule a demo