Collaborate. Contain. Codoxo.
Join the movement to protect your limited healthcare dollars with the most powerful, effective AI in the industry.
1 billion
CLAIMS
PROCESSED
$500M
SAVINGS
%
FALSE POSITIVES
%
INCREASE IN
PRODUCTIVITY
It’s time to break the spiraling cost trends of healthcare fraud, waste and abuse. Codoxo’s Unified Cost Containment Platform works across the payment spectrum to deliver significant savings and a guaranteed 3x ROI.
Fueled by a culture of constant innovation and an incessant drive to ensure client success, our team of collaborators are here to help you disrupt the status quo. Every healthcare payer or agency is unique; we will work with you to identify and meet your specific needs and deliver next-level outcomes.
Join the movement.
Our customers drive savings across payment integrity, SIU, network and clinical teams. We help some of the largest plans and agencies in the country identify opportunities to control costs.
PACIFIC BLUE HEALTH PLAN
Pacific Blues health plan uses Fraud Scope to identify millions in overpayments from a single scheme
READ CASE STUDY >
MIDWESTERN BLUE PLAN
READ CASE STUDY >
6+ million members
Highmark identifies millions in new active cases with AI-powered provider analysis from Codoxo
READ CASE STUDY >
1.5+ million recipients
AI helped Program Integrity Unit at State Medicaid Agency realize a 1,500% ROI
READ CASE STUDY >
3+ million members
Harvard Pilgrim Health Care embraces artificial intelligence from Codoxo to detect FWA issues
READ CASE STUDY >
National Health Plan
Codoxo validates Fraud Scope catches 97% of post-payment exposure
READ CASE STUDY >
700+ thousand members
Several departments at this plan use our AI solutions to meet their needs
2.5+ million members
Ensures fraud and payment integrity teams are using AI to protect the plan
3.5+ million members
Large plan protects public health funds by proactively identifying ways to control healthcare costs with Codoxo
Join the movement.
Our customers drive savings across payment integrity, SIU, network and clinical teams. We help some of the largest plans and agencies in the country identify opportunities to control costs.
6+ million members
Highmark identifies millions in new active cases with AI-powered provider analysis from Codoxo
READ CASE STUDY >
1.5+ million recipients
AI helped Program Integrity Unit at State Medicaid Agency realize a 1,500% ROI
READ CASE STUDY >
3.5+ million members
Large plan protects public health funds by proactively identifying ways to control healthcare costs with Codoxo
700+ thousand members
Several departments at this plan use our AI solutions to meet their needs
2.5+ million members
Ensures fraud and payment integrity teams are using AI to protect the plan
3+ million members
Harvard Pilgrim Health Care embraces artificial intelligence from Codoxo to detect FWA issues
READ CASE STUDY >
– Brian Robinson, Director of Special Investigations Units
HARVARD PILGRIM HEALTH CARE
– Brian Robinson,
Director of Special Investigations Units
HARVARD PILGRIM HEALTH CARE
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.