Shift Payment Integrity

Shift Payment Integrity

Shift Technology
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About

CoverSelf’s healthcare-specific, next-gen, cloud-native, and customizable claims accuracy platform is built from the ground up using modern software development techniques. It empowers users' long-term success by smoothly adapting to ever-evolving, dynamic claims, and payment inaccuracies, reducing complexities and administrative costs. This platform provides open access to all partners working to address claims inaccuracies, administrative waste & inefficiency, enabling them to build, customize, innovate & release at a faster pace. CoverSelf’s payment integrity platform engages modern technologies to address payment leakage & inaccuracies while remaining transparent & accessible to payers. Helps create new scenarios & data mining algorithms, innovating products, and expediting customization through this purpose-built platform, and increases speed to innovation. Claims are corrected and processed automatically, ensuring that there’s no additional human intervention or effort required.

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

Health organizations searching for a platform to manage, ideate, and execute their payment integrity programs

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

CoverSelf
United States
www.coverself.com

Company Information

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

Alternatives

Alternatives

Shift Claims

Shift Claims

Shift Technology
ZOLL Billing

ZOLL Billing

ZOLL Data Systems
Alaffia

Alaffia

Alaffia Health
MarvelX AI

MarvelX AI

MarvelX.ai

Categories

Categories

Integrations

No info available.

Integrations

No info available.
Claim CoverSelf and update features and information
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