AI Solutions for Healthcare

INTRODUCING

ClaimPilot

Generative AI for Payment Integrity

INTRODUCING

ClaimPilot

Generative AI for Payment Integrity

Looking for a copilot for your payment integrity team?

Codoxo is at the forefront of a movement that will not only help healthcare payers and agencies but will also impact the greater good of the healthcare system. Every year, billions of dollars are lost to fraud, waste and abuse. We see a better way. You need a partner who is acting today to solve tomorrow’s most pressing issues. We invite you to join us in making an impact on healthcare affordability and effectiveness. That’s seeing tomorrow, today.

codoxo product diagram

The Codoxo Unified Cost Containment Platform

Leading AI solutions for unified healthcare cost containment.

Smarter, faster, better.

Not all AI is created equal. Codoxo’s patented AI technology uses the most effective AI to ensure payment integrity as well as to anticipate and find fraud, waste and abuse issues our competitors cannot. Our remarkable speed to detection and deployment will help you stop the bleeding sooner for greater cost containment. Codoxo’s Unified Cost Containment Platform applies AI across the cost containment spectrum, including:

• Payment Integrity >
• Fraud, Waste, and Abuse >
• Provider Coding and Billing Education >
• Prior Authorization Acceleration >
• Network Integrity & Contract Management >
• Audit Case Management and Workflow >
• Outsourced Virtual Services >

Leading AI solutions for healthcare cost containment.

Smarter, faster, better.
codoxo product diagram

Not all AI is created equal. Codoxo’s patented AI technology uses the most effective AI to ensure payment integrity as well as to anticipate and find fraud, waste and abuse issues our competitors cannot. Our remarkable speed to detection and deployment will help you stop the bleeding sooner for greater cost containment. Codoxo’s Healthcare Integrity suite applies AI across the cost containment spectrum, including:

The Codoxo Healthcare Integrity Suite

1 billion

CLAIMS

PROCESSED

$500M

IDENTIFIED

SAVINGS

%

REDUCTION IN

FALSE POSITIVES

%

INCREASE IN

PRODUCTIVITY

We invest heavily in our people and our technology to help us push the boundaries of what’s possible.
We have helped achieve savings at world-class payers and healthcare agencies including:

Highmark

6+ million members

State Medicaid Agency

1.5+ million recipients

Southeast Health Plan

3.5+ million members

Pacific Health Plan

700k+ members

Mid-State Health Plan

3.5+ million members

Midwest Plan

2.5+ million members

We invest heavily in our people and our technology to help us push the boundaries of what’s possible.

We have helped achieve savings at world-class payers and healthcare agencies including:

Highmark

6+ million members

State Medicaid Agency

1.5+ million recipients

Southeast Health Plan

3.5+ million members

Pacific Health Plan

700k+ members

Mid-State Health Plan

3.5+ million members

Midwest Plan

2.5+ million members

– Kurt Spear, Vice President Financial Investigations and Provider Review
HIGHMARK

– Kurt Spear, Vice President Financial Investigations and Provider Review
HIGHMARK

Resources

Codoxo

Leading a Movement to Contain Healthcare Costs and Disrupt the Status Quo. See why our mission to contain healthcare costs has sparked a movement. A movement that includes collaborating with payers and agencies across the U.S. to deploy AI solutions that disrupt the status quo of unsustainable healthcare costs. That’s seeing tomorrow, today.

Using AI to Power Successful Unified Cost Containment Programs

5 best practices to using AI solutions for a holistic approach that breaks down silos while improving efficiency, transparency and insight, contributing to better healthcare.

Unified Cost Containment Platform

Download and share an overview of everything the Unified Cost Containment Platform can do for your organization.

Ready for a better solution?

Request a demo to learn what we can do for you.

FORENSIC AI PLATFORM

Our Forensic AI Engine analyzes your data, detects problems, and builds connections across your data to provide actionable insights

Insight Scope

For everyone across the health plan

Clinical Scope

For clinical teams

Audit Scope

For everyone across the health plan and PBM

Network Scope

For network teams

Payment Scope

For payment integrity teams

Provider Scope

For network and payment teams

Fraud Scope

For SIU teams

SERVICES

We provide a full range of professional services, from data migration and ongoing customer success through flexible virtual SIU options.