A complete approach

Claims editing

Maximize savings with dynamic, agent powered edits consistently updated to any policy or code changes; provide decisions with confidence, context and transparency

Data mining

Analyze claims data for anomalies, outliers and activity trends with consistently updated, comprehensive concepts and models for increased recovery opportunities

FWA detection

Uncover evolving schemes, high-value errors & potential FWA with agent-powered scenarios, document analysis, and network-level detection and lead packaging

Integrated workflow tools

Streamline workflows, increase collaboration, manage caseloads, audit claims and providers, and track activity all in a single platform

Easy implementation

Accelerate initial and future deployments with a single, any-form data integration that fuels Shift’s entire payment integrity solution; minimizing health plan IT lift while maximizing speed to value

Agentic AI to improve payment accuracy

Maximize savings

Prevent and capture more value with agent powered edits and detection logic that uncovers emerging schemes.

Optimize detection

Improve accuracy with agentic AI that automatically updates claims edits and detection logic to reflect shifting policies, code sets, and care delivery models.

Reduce provider friction

Lower appeals and administrative pushback by delivering transparent, explainable decisions backed by specific policy and clinical context.

Accelerate workflows

Enhance team productivity and impact with agentic automation and a single platform that transforms complex findings into clear, defensible action.

Strategic health plans choose Shift

icon_cube_color

Unmatched AI-ready data

Built on billions of insurance-trained, AI-ready data elements, Shift AI agents are purpose-built to deliver high quality outcomes that insurers trust

icon_star-badge_color

Deep healthcare expertise

Decades of industry experience with plan processes, systems, and data enables Shift AI and our accredited experts to anticipate and drive lasting transformation

icon_group-shapes_color

Human + AI collaboration

Human-in-the-loop by design, Shift agents work alongside human experts, ensuring every action is transparent and auditable

icon_badge-star_color

Demonstrated impact

Trusted by the world's leading insurers to turn reactive processes into real-time results: lower losses, faster cycles, and superior customer experiences