Shift Payment Integrity

Shift Payment Integrity

Shift Technology
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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.

About

​Simplifai is an AI automation platform that streamlines business operations by automating complex processes, particularly in sectors like banking, finance, insurance, and the public sector. It offers solutions for document handling, customer service, and claims processing, utilizing advanced AI technologies to reduce manual effort and increase accuracy. It enhances customer support by automating responses and managing inquiries efficiently. Adhering to GDPR and ISO/IEC 27001:2013 standards, Simplifai ensures robust data security and compliance. Its AI agents are designed to address challenges such as increasing operational costs, low customer satisfaction, and scalability issues, delivering fast and accurate service while reducing errors. Simplifai provides a 360-degree view of claims, policies, and accounts, improving customer service and vendor management. By leveraging Simplifai, organizations can ensure accurate financial records, minimize manual work, etc.

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 plan administrators and healthcare organizations in need of a tool to reduce improper payments, detect emerging fraud and billing errors, and improve claims workflows

Audience

Businesses in banking, finance, insurance, and public sectors needing a solution to automate complex processes and enhance operational efficiency

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

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

Company Information

Simplifai
Founded: 2017
Norway
www.simplifai.ai/

Alternatives

Alternatives

Shift Claims

Shift Claims

Shift Technology
Alaffia

Alaffia

Alaffia Health
MarvelX AI

MarvelX AI

MarvelX.ai
AgentFlow

AgentFlow

Multimodal

Categories

Categories

Integrations

No info available.

Integrations

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