Health Insurance

An evolving problem calls for an evolved approach

Healthcare fraud, waste and abuse costs US healthcare billions of dollars every year. Overwhelmed with suspicious alerts, evolving schemes and scattered data sources, health plans need to evolve their fight against this growing problem. Shift is revolutionizing the detection and management of fraud, waste, and abuse by delivering unparalleled AI-driven insights to help health plans take action with speed, impact and accuracy.

• Increased accuracy thanks to insurance-trained AI. Shift enables payers to identify suspicious claims, providers, and third parties based on continually updated scenarios.
• Faster investigations powered by explainable AI decisioning tailored to the needs of users throughout the healthcare insurance organization.
• Reduced costs thanks to prioritized guidance focused on maximizing revenue preservation.
• Improved efficiency in driving better patient outcomes, optimizing provider performance, and maintaining compliance.