Shift Payment IntegrityShift Technology
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Related Products
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About
Cluda is an AI-powered insurance policy analysis, comparison, and renewal automation platform designed to help brokers and insurance professionals streamline their back-office workflows by eliminating manual checks, reducing errors, and speeding up key tasks. It uses intelligent document ingestion to upload and standardize complex policy documents in formats like PDF and Word, automatically extracts key data and clauses using advanced OCR and AI, and generates clear side-by-side policy comparisons that highlight differences in coverage, exclusions, and terms with direct links back to the source documents for verification, reducing the risk of missed changes and compliance issues. Cluda also maps extracted and compared data into branded renewal reports using firm-specific templates, saving hours of manual reporting and enhancing client communications, and it supports an AI-driven assistant for coverage queries and policy insights.
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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.
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Platforms Supported
Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Platforms Supported
Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Audience
Brokers and commercial insurance professionals interested in a tool to analyze, compare, and report on policy documents quickly and accurately
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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
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Support
Phone Support
24/7 Live Support
Online
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Support
Phone Support
24/7 Live Support
Online
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API
Offers API
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API
Offers API
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Screenshots and Videos |
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Pricing
No information available.
Free Version
Free Trial
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Pricing
No information available.
Free Version
Free Trial
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Reviews/
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Reviews/
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Training
Documentation
Webinars
Live Online
In Person
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Training
Documentation
Webinars
Live Online
In Person
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Company InformationCluda
Founded: 2024
United States
www.cluda.ai/
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Company InformationShift Technology
Founded: 2013
France
www.shift-technology.com/products/payment-integrity
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Integrations
Microsoft Word
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