Fraudsters don’t play by the rules. Your detection strategy shouldn’t either.
Shift’s healthcare-trained AI models go beyond static, rules-based detection methods to increase detection accuracy, uncover higher-value healthcare fraud, waste and abuse, and boost the efficiency of investigators.
Investigators should spend their time investigating. They shouldn’t waste time combing through sources for the right data or information. With enhanced plan data, combined with extensive external data, Shift gets the right insights to investigators faster.
Investigative detail all in one place
Uncover related providers
Alerts with context and action
Any data, any format
Powerful detection across the full Payment Integrity lifecycle
TIME TO SHIFT AWAY FROM THE TRADITIONAL FWA DETECTION APPROACH
Healthcare fraud, waste and abuse is constantly changing - is the traditional approach enough? Dive into the traditional approaches to fraud, waste and abuse detection using rules-based tactics and the increasing shortfalls in relation to evolving fraud and demands from health plans. Learn how an AI-driven approach to improper payment detection can upend traditional approaches, with actionable insights and increased collaboration across the plan.