Case Study: a large regional health plan achieves rapid claim edit deployment and immediate savings with Shift Technology

Large Regional Health Plan deploys claim edits in 4 days with Shift Technology

Shift Technology conducted a risk assessment for a large regional health plan and discovered a significant challenge: the plan lacked foundational claim edits, which was leading to rising outpatient overpayments and creating a window of financial exposure.

Using generative AI, Shift Technology quickly ingested and transformed large volumes of CMS source files into production-ready logic tailored to the plan's needs. The solution was built, tested, and deployed in under four days. This resulted in immediate savings for the health plan by closing the exposure gap.