Uncover how AI technology can be your cost containment solution.

With a mission to make healthcare more affordable and effective for everyone, Codoxo is the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud, waste, and abuse and ensure payment integrity. The Codoxo Unified Cost Containment Platform helps clients manage costs across network management, clinical care, provider coding and billing, payment integrity, and special investigation units. Our software-as-a-service applications are built on our proven Forensic AI Engine, which uses patented AI-based technology to identify problems and suspicious behavior far faster and earlier than traditional techniques.

We differentiate and distinguish ourselves with the Codoxo difference:

1. The Most Effective, Academic Developed AI, allowing our partner clients to control healthcare costs faster and with greater accuracy than with traditional methods. Codoxo’s core AI capability was developed by academic researchers at the Georgia Institute of Technology to identify new emerging healthcare payment integrity and fraud schemes proactively. Today, the company employs several PhD research scientists from leading institutes like MIT. Only Codoxo delivers AI built from the ground up specifically to contain healthcare costs and deliver substantial ROI through early detection, automation, and a single, transparent platform. Our advanced AI ensures payment integrity by seeking and predicting new fraud, waste, and abuse patterns and identifying existing problems before they affect your bottom line. We’ve identified over $500 million in savings since 2017 and delivered an average 15:1 ROI for our customers.

2. Codoxo's Unified Cost Containment Platform is the only platform in the market today unifying data and teams within a single platform. Our platform can be applied across multiple departments, including payment integrity, fraud, waste, and abuse, provider coding and billing education, network integrity and contract management. Our platform analyzes various claim types, including professional, facility, pharmacy, behavioral, dental, vision, and workers' compensation, to create connections across the data to detect problems and provide actionable insights rapidly. With one platform, cost containment teams are able to break down silos across departments, data types, and claim systems whole all collaborating and gaining real-time visibility on the same claims data.

In addition to our SaaS solutions, our team can  supplement your staff with outsourced virtual services such as claims audit, medical records reviews and end-to-end SIU services.

3. Speed to Implementation, Detection and Insights enable partner clients to realize faster time to value and outcomes. Our solutions can be implemented in weeks instead of months, allowing cost containment teams to quickly identify current and emerging threats and take action quickly.

4. Innovation: is at the heart of what we do and Codoxo continues to raise the bar for the payment integrity industry by launching innovative solutions that will become the norm in the future. We are at the forefront of the generative AI movement that will help healthcare payers and agencies impact the greater good of the healthcare system. Recently, released our generative AI solution, ClaimPilot. We are very excited about the future of ‘zero touch’ Payment Integrity, and we believe that ClaimPilot will be the ‘game-changing’ solution to automate expensive inpatient and facility claim audits. What once took a few days can now take less than 24 hours to complete medical chart reviews. ClaimPilot aims to drive an exponential increase in audit turnaround times and clinician audits per day while eliminating dollar thresholds that restrict claims analysis to higher dollar ranges.

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