Data Mining Services

Uncover More Overpayments & Increase Recoveries with AI-Driven Healthcare Data Mining Services

Codoxo’s Data Mining Services help uncover additional overpayments for recovery with precision and efficiency. Leveraging advanced AI tools, our payment integrity experts identify anomalies and outliers often overlooked by other solutions.

Healthcare data mining expert reviewing data on screen using data mining tools

Ready to Realize $5 PMPY on Your Data Mining Efforts?

Codoxo’s Data Mining Services combine cutting-edge AI with expert analysis to uncover missed overpayments, detect anomalies, and flag waste, abuse and errors in billing and payment. Offering flexible service options, Codoxo can manage some or all aspects of the data mining process — ranging from initial identification to provider outreach and recovery efforts — tailored to meet each client’s unique needs for seamless and efficient results.

Empower your payment integrity team with maximized recoveries while reducing manual workloads.

Maximizing Overpayment Detection & Recovery with AI-Powered Data Mining Services

Healthcare payment integrity teams face increasing pressure to detect overpayments, abuse, waste, and billing errors while managing resource constraints. Offloading data mining to Codoxo allows these teams to leverage advanced AI and expert analysis to uncover anomalies and recover funds with greater accuracy and speed. By outsourcing these labor-intensive tasks, teams can focus on strategic initiatives, improve program efficiency, and achieve better financial outcomes without the operational burden.

Improve recovery outcomes

By uncovering patterns missed by traditional data mining tools

Identify overpayments, billing errors, waste & abuse

Faster, with AI analysis

Free internal teams from labor-intensive tasks

Enabling greater focus on higher-value initiatives

Customize services to your organization’s needs

From anomaly detection to fund recovery

Unlock the Full Potential of Data Mining With Advanced AI Technology

  • Customizable services
    Tailored to meet client-specific needs, Codoxo’s Data Mining Services provide flexible options, from detection to recovery pursuit
  • Expert-led analysis with AI data mining tools
    Advanced AI algorithms identify anomalies, billing errors, waste, and abuse in healthcare claims with unmatched precision
  • Overpayment identification & recovery
    Proprietary AI detects overpayments with unmatched accuracy, outperforming traditional rules-based methods to maximize recoveries
  • Provider outreach & recovery pursuit
    Codoxo’s team can manage recovery efforts, including communication, dispute resolution, and fund collection, using customizable templates and a secure provider portal

Identify More Recoveries & Achieve Improved Data Mining Results With Outsourced Data Mining Services

Identified

$162,000 in recoveries for one code, for one payer

Detected

provider billing multiple units of per diem code

Identified 

multiple misused codes for Medicare population

Revealed

code pairs that rules-based edits missed

Smarter Healthcare Cost Containment Starts With Codoxo

Data Mining Services are delivered through Codoxo’s Unified Cost Containment Platform, empowering healthcare organizations to take a seismic shift left by ensuring faster, more accurate claim payments, reduced fraud, waste, and abuse, and enhanced operational efficiency. By transforming the landscape of healthcare cost containment and payment integrity with industry-leading AI, Codoxo is at the forefront of making healthcare more affordable and effective.

Explore Codoxo’s Unified Cost Containment Platform
Products & Services

One platform for complete prepayment and postpayment cost containment in healthcare
Provider Scope

Bring down costs pre-claim with proactive and automated provider education.

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Audit Scope

Automate and streamline end-to-end audit detection and workflow while ensuring compliance.

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Fraud Scope

Automatically and accurately detect new and emerging fraud schemes, streamline evidence chain collections, and integrate workflows for FWA investigations.

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Payment Scope

Identify claim accuracy issues before claims are paid with unique claim insights, easy-to-use claim workflow, and automated provider outreach.

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Clinical ClaimPilot

Automate medical record reviews with generative AI, speeding up reviews and increasing audit accuracy.

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Compliance ClaimPilot

Validate provider contracts and medical policies to ensure payment accuracy and reduce manual errors.

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Concept Claimpilot

Accelerate concept development of new claim payment methods and proactively spot payment gaps with generative AI.

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Medical Record Reviews Services

Speed turnaround times and increase accuracy for in-patient, facility, and DRG audits with generative AI-driven medical record reviews services.

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Data Mining Services

Uncover more overpayments with AI-driven outsourced healthcare data mining services.

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Virtual SIU Services

Offload SIU compliance and scale operations through end-to-end virtual resources and services.

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Uncover Hidden Insights in Your Data.