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ClaimShark, our Payment Integrity orchestration platform and AuditShark, our claim audit platform, offer multiple modules to help Health Plans manage their Payment Integrity operations. Built for the cloud, the modules can operate in tandem or independently with any of the Plans internal systems. Our data layer seamlessly connects the modules with each other and existing client platforms. Click here for an overview of our offerings.
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Despite the best efforts, Health plans leave money on the table when it comes to Payment Integrity. Health Plans lose millions of dollars to expired claims after doing all the work. Claims with valid overpayments sit in the recovery and offset status and expire due to lack of resources or focus. Your valuable PI team members may be working on tasks that are necessary, but below their pay grade or expertise

ClaimShark can help with volume and velocity of your savings. Our technology and tools along with your expertise can increase and accelerate your Payment Integrity savings. To know more about our services Visit our services page
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Blog

Overcoming The Administrative Challenges of Medicaid Redetermination

Managing these challenges without the right technology platforms, automation, and use of artificial intelligence will be nearly impossible and cause exponential administrative challenges for health plans.

ChatGPT and AI’s Impact on Payment Integrity

Generative AI is already having an impact on the healthcare industry and will play a crucial role in the future evolution of modern healthcare. It’s already making progress in areas like research, drug discovery, medical transcription, medical diagnosis, documentation etc.

Increase your TPL savings Better compliance | Higher Productivity

ClaimShark TPL/COB platform (Cobalt) can triple your internal savings with the existing team. Cobalt gives your team a comprehensive TPL/COB platform that can bring in multiple data files (TPL, back sweep, CAQH etc.)

Blog

Overcoming The Administrative Challenges of Medicaid Redetermination

ChatGPT and AI’s Impact on Payment Integrity

Increase your TPL savings Better compliance | Higher Productivity

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Blog

Overcoming The Administrative Challenges of Medicaid Redetermination

ChatGPT and AI’s Impact on Payment Integrity

Increase your TPL savings Better compliance | Higher Productivity