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

About Shift Payment Integrity

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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Company Information

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

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Product Details

Platforms Supported
Cloud
Training
Documentation
Live Online
Webinars
Videos
Support
Online

Shift Payment Integrity Frequently Asked Questions

Q: What kinds of users and organization types does Shift Payment Integrity work with?
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