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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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Data Hub & Vendor Management

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AuditShark

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Compliance Audits
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Services
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
Automation

Data Aggregation

Validation

AI & Machine Learning

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