Shift Payment Integrity

Shift Payment Integrity

Shift Technology
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About

Poetic is an AI system that learns like AI but executes with the precision of code. It is designed to turn procedures, training materials, recordings, workflow screenshots, and historical examples into working operational automations. Teams can upload SOPs, PDFs, training sessions, and other process documentation, and Poetic reviews those materials to create the first draft of an automated workflow. It then learns from expert feedback, improving based on the guidance of the organization’s most talented operators until it reaches production quality. In the product example, Poetic reviews a dispute case, checks card freeze and unfreeze events, explains the investigation result, shows the evidence used, and accepts feedback to improve the decision process, such as widening the review window to catch more first-party fraud patterns and improve decision quality.

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

Operations teams in regulated enterprises that need AI-driven automation to turn SOPs, expert feedback, and changing workflows into reliable production processes

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

Poetic
Founded: 2023
United States
poetic.com/product

Company Information

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

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Categories

Categories

Integrations

No info available.

Integrations

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