Uncover Healthcare Fraud, Waste and Abuse With Speed and Accuracy. Detect and prevent improper payments with a focus on high-value cases and maximum ROI.
Vendor
Shift Technology
Company Website
Overview
Shift Improper Payment Detection is an AI-driven solution designed to combat healthcare fraud, waste, and abuse (FWA). This system moves beyond traditional, rules-based detection methods, employing healthcare-trained AI models to significantly enhance detection accuracy. By identifying higher-value instances of FWA, it enables investigators to focus on the most impactful cases. The software provides investigators with all necessary details in one centralized location, eliminating the need to comb through multiple sources. Enhanced plan data is combined with extensive external data to deliver actionable insights faster. The system also uncovers related providers involved in potential FWA schemes and delivers alerts with context and recommended actions. It is designed to work with any data in any format, providing flexibility and ease of integration.
Features
- Healthcare-trained AI models
- Enhanced plan data
- Extensive external data integration
- Comprehensive investigative details in one place
- Identification of related providers
- Contextual alerts with recommended actions
- Compatibility with any data format
Benefits
- Increased detection accuracy
- Uncovers higher-value fraud, waste and abuse
- Boosts investigator efficiency
- Reduces time spent gathering data
- Provides actionable insights