Combat Fraud, Waste, and Abuse in Healthcare with Shift’s Improper Payment Detection Solution
Our latest whitepaper is now available for download. Fill in your details below.
Health plans have massive amounts of data available in health records, clinical trials, and billing & claims processing systems. However, it’s challenging to unlock the value buried in this data to streamline claims payments, reduce improper payments, drive better provider network performance, and maintain regulatory compliance.
Shift Improper Payment Detection provides an efficient, high-impact approach to identifying fraud, waste and abuse for health plans. By leveraging enhanced data and artificial intelligence, the solution provides the insights investigators need to maximize savings for health plans. It gives users within a health plan the ability to analyze behaviors and actions across multiple lines of business—individual providers and provider networks, third parties, plan members, and more.
Shift Improper Payment Detection provides an efficient, high-impact approach to identifying fraud, waste and abuse for health plans. By leveraging enhanced data and artificial intelligence, the solution provides the insights investigators need to maximize savings for health plans. It gives users within a health plan the ability to analyze behaviors and actions across multiple lines of business—individual providers and provider networks, third parties, plan members, and more.
In our whitepaper, “A New Approach to Improper Payment Detection: Beyond the Alert Queue,” we discuss how Shift enables health insurers to:
- Identify & investigate fraud, waste, and abuse more effectively
- Reduce losses due to improper payments
- Prioritize investigative resources based on ROI
- Improve investigator efficiency and shorten decision time-frames
- Optimize provider network performance