Shift Payment IntegrityShift Technology
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Related Products
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About
Facio provides AI-native software infrastructure for specialty insurance organizations, including MGAs. Our platform, FacioMGA, supports the policy lifecycle: submission intake, risk classification, underwriting, quoting, binding, policy issuance, endorsements, billing, commissions, compliance, reporting, renewals and integrations. Customers configure products, rating rules, eligibility criteria, workflows, documents and permissions without rebuilding technology for each program. Facio offers standalone solutions for surplus-lines tax and fee calculation, SIC/NAICS classification, sanctions screening, actuarial operations and automated carrier-declination workflows. Our Org2vec technology creates an evidence-backed memory by connecting policies, contracts, financial records, assets, suppliers, cybersecurity systems and operational data, while Facio Eigen provides a zero-trust control layer that applies permissions, rules, approvals and audit trails to AI-assisted decisions and actions.
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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
Facio benefits MGAs, insurers, brokers, reinsurers, government agencies and other regulated organizations seeking to replace fragmented legacy systems and manual processes with configurable, auditable and securely governed AI-powered infrastructure.
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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 VideosNo images available
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Pricing
$65/mo./user + cloud
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 InformationFacio
Founded: 1600
United States
www.facio.io
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Company InformationShift Technology
Founded: 2013
France
www.shift-technology.com/products/payment-integrity
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Integrations
No info available.
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Integrations
No info available.
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