Medical Record Review & Chart Review Solutions
Comprehensive medical record review solutions, powered by generative AI, deliver unmatched payment accuracy and efficiency for healthcare payers.
Healthcare payers face increasing complexity in medical record reviews, from validating diagnosis codes to ensuring DRG payment accuracy. Codoxo’s comprehensive medical record review solutions combine generative AI solutions with clinical expertise for improved efficiency and accuracy.
Ready to Complete Medical Record Reviews in Hours vs Weeks?
Our Payment Integrity Solutions Span the Complete Spectrum of Healthcare Auditing Needs
From DRG reviews and clinical chart reviews to itemized bill reviews and specialized medical record reviews. By integrating cutting-edge AI technology with experienced clinical reviewers, we deliver faster, more accurate results than traditional review methods.
Our medical record review solutions include:
- Medical Record Reviews for DRG Audits: Expert validation of diagnosis codes and DRG assignments to ensure payment accuracy and coding compliance
- Clinical Chart Reviews: Thorough evaluation of medical records for treatment appropriateness and level of care determinations
- Itemized Bill Reviews: Detailed analysis of facility charges and billing accuracy
- Payment Integrity Reviews: Comprehensive validation of claims and medical documentation
- Prepayment Chart Reviews: Proactive medical record reviews before payment to prevent costly recoveries
- Short Stays: Validation of billing accuracy for patient short stays
Each review type leverages our generative AI for healthcare, processing hundreds of pages of medical documentation while maintaining the highest standards of accuracy.
Unlock Faster Medical Record Reviews with the Industry’s Most Advanced Solutions
Operating with constrained resources, healthcare payment integrity teams face mounting difficulties in ensuring payment accuracy, meeting compliance standards, and handling intricate claim reviews. By harnessing Codoxo’s advanced AI and generative AI-powered solution for medical record reviews, payment integrity teams can drive dramatic efficiencies that give them the freedom to focus on higher-value program initiatives.
Accelerate
medical chart review
Turnaround times from weeks to under 24 hours
Enhance
DRG audit accuracy
With AI-powered diagnosis code validation
Improve
payment accuracy
Across all types of medical record reviews
Scale
chart review capacity
To over 20 reviews per day
Increase
review capacity
By eliminating dollar limits and enabling unlimited claims evaluations
Strengthen
payment integrity
Programs through comprehensive documentation review
Increase
recovery identification
While reducing administrative burden
Ensure
adherence
To regulatory and contractual standards with comprehensive, expert-led reviews
Expedite Complex Medical Record Reviews While Increasing Recoveries
- Generative AI Document Analysis
Advanced AI technology efficiently processes thousands of pages of medical records, clinical documentation, and itemized bills and automatically extracts and validates diagnosis codes and clinical indicators with high precision, eliminating manual review time - Comprehensive DRG Validation
Execute automated DRG audit workflows that incorporate sophisticated clinical logic verification. The platform performs real-time accuracy checks against current coding guidelines and medical necessity criteria to ensure compliant reimbursement - Intelligent Payment Integrity Controls
Our solution meticulously cross-validates medical records against claims data while identifying potential coding discrepancies and compliance issues. This comprehensive approach ensures payment accuracy across all types of medical record reviews - Advanced Clinical Review Automation
Streamline your medical chart review workflows through intelligent automation that applies evidence-based criteria for medical necessity validation. The system supports multiple review types from prepayment to postpayment, ensuring consistent accuracy throughout the payment cycle
- Multi-Specialty Review
Access customized review protocols designed specifically for different medical specialties, including specialty-specific diagnosis code validation. The system enables targeted itemized bill review by service type, ensuring appropriate reimbursement across all specialties - Provider Collaboration Platform
Enhance provider relationships through secure document exchange capabilities and automated communication workflows. The system streamlines documentation requests and presents clear findings to reduce provider abrasion - Performance Analytics Dashboard
Monitor your program’s success through real-time tracking of review outcomes, payment accuracy metrics, and ROI measurements. The system provides detailed turnaround time monitoring to help optimize operational efficiency
Break the Status Quo with Codoxo’s Medical Record Reviews Solution
Reduces
Increases
Scales
Improves
Streamlines
Delivers
Explore Codoxo’s Full Solutions Offerings
Smarter Healthcare Cost Containment Starts With Codoxo
Codoxo’s medical record and chart review solutions are delivered through our 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.
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