Medical Record Reviews Services

Accelerate Medical Record Reviews with Generative AI for Unmatched Efficiency & Payment Accuracy
Codoxo’s medical record review services harness generative AI to offload time-consuming clinical reviews — freeing your team from heavy administrative tasks while ensuring accurate payments.
Payment accuracy leader conducting a clinical review with medical record review services on her computer

Ready to Complete Medical Record Reviews in Hours vs. Weeks?

Codoxo’s Medical Record Reviews Services help healthcare payers tackle one of healthcare’s biggest challenges: automating complex clinical reviews. By offloading this time-consuming task, including reviewing hundreds of pages of medical records and hospital bills, Codoxo relieves clinicians of administrative burdens while completing reviews faster, and with greater accuracy.

Our expert clinical auditors deliver comprehensive medical record reviews services powered by market-leading generative AI technology. From identifying potential overpayments, selecting claims for review, conducting thorough evaluations, and, when necessary, collaborating directly with providers, we can offload medical record reviews while augmenting your payment accuracy programs.

Codoxo’s medical record review services include:

  • Itemized Bill Reviews
  • In-patient Audits
  • Facility Audits
  • DRG Validation
  • DRG Clinical Validation
  • Short Stay
  • Readmission

Unlock Faster Medical Record Reviews with Advanced AI & Gen AI-Driven Services

Operating with constrained resources, healthcare payment integrity teams are facing mounting difficulties in ensuring payment accuracy, meeting compliance standards, and handling intricate claim reviews. By outsourcing medical record reviews to Codoxo, payment integrity teams augment cost containment efforts, enhance compliance, and allow internal teams to focus on driving impactful program outcomes.

Increase recoveries

Find additional opportunities for recoveries without exhausting payment integrity team resources

Ensure adherence to regulatory & contractual standards

With comprehensive, expert-led reviews

Manage a higher volume of reviews

Generative AI-driven reviews create extreme automation for unlimited analysis across claims

Remove dollar thresholds

Often limited to high dollar claims, reviews can be performed across all dollar values for greater recovery opportunities

Free internal teams

Concentrate payment integrity teams on higher-value initiatives, such as program development and optimization

Offload Your Payment Integrity Team While Increasing Recoveries

  • End-to-end services
    From detection to recovery
  • Comprehensive program reporting
    Including audit impact analysis
  • Generative AI-powered reviews
    Break down barriers, streamlining the challenges of traditional manual review processes

Break the Status Quo with Codoxo’s Medical Record Reviews Services

Reduces
audit turnaround times from weeks to less than 24 hours
Increases
daily audits from 2-3 to over 20
Enables
auditing of all claim types, without being limited by dollar thresholds
Delivers

immediate impact on both prepay and postpay programs

Smarter Healthcare Cost Containment Starts With Codoxo

Medical Record Reviews 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 operational optimization. By transforming the landscape of healthcare cost containment and payment integrity with industry-leading AI, Codoxo is at the forefront of making healthcare more efficient.

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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Ready To Transform Your Payment Integrity Processes?