Shift Payment Integrity

Shift Payment Integrity

Shift Technology
+
+

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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.

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

Brokers and commercial insurance professionals interested in a tool to analyze, compare, and report on policy documents quickly and accurately

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

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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

Cluda
Founded: 2024
United States
www.cluda.ai/

Company Information

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

Alternatives

Alternatives

Shift Claims

Shift Claims

Shift Technology
MarvelX AI

MarvelX AI

MarvelX.ai
MarvelX AI

MarvelX AI

MarvelX.ai
Alaffia

Alaffia

Alaffia Health

Categories

Categories

Integrations

Microsoft Word

Integrations

Microsoft Word
Claim Cluda and update features and information
Claim Cluda and update features and information
Claim Shift Payment Integrity and update features and information
Claim Shift Payment Integrity and update features and information