CLAIMExpert

CLAIMExpert

Acrometis
Shift Payment Integrity

Shift Payment Integrity

Shift Technology
+
+

Related Products

  • Service Center
    122 Ratings
    Visit Website
  • XpertCoding
    42 Ratings
    Visit Website
  • Macaw AMS
    8 Ratings
    Visit Website
  • RegDesk
    19 Ratings
    Visit Website
  • RXNT
    552 Ratings
    Visit Website
  • PayHOA
    671 Ratings
    Visit Website
  • optivalue.ai
    4 Ratings
    Visit Website
  • Soraban
    6 Ratings
    Visit Website
  • Valant Behavioral Health EHR
    354 Ratings
    Visit Website
  • ManageEngine Log360
    187 Ratings
    Visit Website

About

The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs. CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making. Automatically processes incoming documents with NO adjuster intervention. Clients typically see between 11 and 23 points medical loss improvement in the first year. CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk.

About

Shift’s Payment Integrity is an AI-powered solution for health plans designed to improve accuracy and reduce costs in the claims payment process. It works both pre-payment (before claims are paid) and post-payment, helping plan administrators catch issues early and recover overpayments. Key features include claims editing (with updated, dynamic rules), generative AI-assisted medical record review, anomaly & fraud/waste/abuse detection, and external data enrichment for deeper context. The system supports evolving policy and guideline changes, allowing automated policy analysis and edit logic workbench features so health plans can test concepts before deployment. It provides explainable flags/alerts (so reviewers understand why claims are flagged), tools to accelerate document review, highlighting relevant parts of records, data mining for emerging trends, and a unified case management UI for investigative workflows.

Platforms Supported

Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Platforms Supported

Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Audience

Companies searching for a automated Claim Handling Process solution

Audience

Health plan administrators and healthcare organizations in need of a tool to reduce improper payments, detect emerging fraud and billing errors, and improve claims workflows

Support

Phone Support
24/7 Live Support
Online

Support

Phone Support
24/7 Live Support
Online

API

Offers API

API

Offers API

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version
Free Trial

Pricing

No information available.
Free Version
Free Trial

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation
Webinars
Live Online
In Person

Training

Documentation
Webinars
Live Online
In Person

Company Information

Acrometis
Founded: 2002
United States
www.acrometis.com/our-solutions/claimexpert-and-associated-services/

Company Information

Shift Technology
Founded: 2013
France
www.shift-technology.com/products/payment-integrity

Alternatives

Newgen Claims Processing

Newgen Claims Processing

Newgen Software

Alternatives

ClaimBook

ClaimBook

Attune Technologies
Shift Claims

Shift Claims

Shift Technology
Claims Software

Claims Software

Claim Ruler
CyberSource Medical

CyberSource Medical

ComCom Systems
Alaffia

Alaffia

Alaffia Health
MarvelX AI

MarvelX AI

MarvelX.ai

Categories

Categories

Claims Processing Features

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Integrations

No info available.

Integrations

No info available.
Claim CLAIMExpert and update features and information
Claim CLAIMExpert and update features and information
Claim Shift Payment Integrity and update features and information
Claim Shift Payment Integrity and update features and information