AI Solutions for Healthcare

Changing entrenched ways of doing business is daunting in any industry, and healthcare is no exception.

Yet Codoxo is doing just this – transforming standards and affecting positive change in a historically slower-to-adapt industry. Over the past 12 months, Codoxo’s growth, client satisfaction, industry recognition, and improved performance validate that our deep commitment to next-generation healthcare cost containment is making a real difference to healthcare payers,agencies, and PBMs, along with the members and patients they serve.

Here’s a celebration of everything we’ve achieved as we look forward to another exciting year of innovation and meaningful outcomes.

Revenue Growth, Client Satisfaction, Industry Recognition

Fueled by a $20 million Series B funding round in early 2022, Codoxo expanded its healthcare cost containment presence into the Pharmacy Benefits Management (PBM) market given pharmacies’ critical role in serving patient needs.

This strategic expansion was complemented by a significant revenue boost as Codoxo signed some of our biggest contracts of the year for  our Unified Cost Containment Platform. Notably, 40% of Codoxo clients opted to deepen their work with us in 2023, with many signing three-year renewal contracts. We were delighted to learn that our client satisfaction results showed 100% of interviewed clients would invest in Codoxo’s AI platform again and recommend our technology to others.

Our transformative technology and leadership for healthcare payment integrity; fraud, waste, and abuse; and audit case management and workflow continues to receive accolades from several prominent media outlets and analyst firms:

    • Codoxo’s Forensic AI Platform was awarded the 2022 Fierce Healthcare Innovation Award in the Data Analytics/Business Intelligence category.
    • Codoxo was named a “Mighty Player” in Aite-Novarica’s Payment Integrity in Healthcare report for the second year in a row.
    • Codoxo was named the only “Highflier” vendor in CB Insights’ report on Fraud, Waste, & Abuse Analytics Companies for Healthcare and Healthcare Payers Tech.
    • Finally, Codoxo was named by The Atlanta Business Chronicle as one of the fastest-growing companies in Atlanta!

We’re incredibly proud –  and more motivated than ever.

Continued Innovation and Investment in Our Core Technology

Over the past 12 months, Codoxo has made several key technology investments to boost its strategic roadmap based on customer feedback and the need to prioritize emerging market trends in the pre-submission and post-pay healthcare spectrum. Key investments in our core Forensic AI Engine during 2022 included:

    • Provider Scope, Audit Scope & Fraud Scope: Key enhancements were made to the three of our Unified Cost Containment Platform products. Provider Scope incorporated enhancements to the AI-based detection of themes that present the best opportunities for provider behavior change and savings, as well as improvements to the automated outreach campaign module and provider portal to support improved billing practices, maximized coding accuracy, and reduction in provider abrasion. Audit Scope received several AI and rules-based enhancements, as well as automation of both the records request management to providers and audit-related communication. Fraud Scope received new detections related to emerging fraud, waste, abuse, and error; new ways to identify unusual provider behavior; as well as major improvements to case management and reporting.
    • Data Management: Stemming from enhancements to our forensic AI engine, Codoxo can now ensure high accuracy in provider specialty classification – resulting in more accurate peer group analysis and outlier detection.
    • HITRUST: We are especially proud of our HITRUST certified status, since this puts us in an elite group of those who’ve met the highest healthcare industry standards for security and compliance. In 2022, Codoxo was granted a 2-year (r2) renewal on this certified status for the entire unified cost containment platform.
Industry Education and Subject Matter Expertise

As a respected leader in healthcare cost containment, Codoxo hosted several forums last year dedicated to ongoing awareness and education on the fight against fraud, waste, abuse. In March, we brought together thought leaders for a Healthcare Executive Roundtable discussion to address COVID-19 impacts on the industry and how to re-envision strategic alignment in the year ahead. In October, we hosted an inaugural Customer Conference, a private, three-day virtual event, focused on the theme of “Changing the Cost of Containment Landscape through AI innovation.” Additionally, the company’s monthly “Forensic AI Alerts” have continued to gain traction and raise industry awareness around cost containment and payment integrity best practices.

Codoxo advanced its conference education by sponsoring and speaking at several events in 2022 on the topic of cost containment, including at the AHIP Conference, the NAMPI 2022 Annual Conference, the Pharmacy Benefit Management Institute (PBMI) and at the National Health Care Anti-Fraud Association (NHCAA). We also had the privilege of sponsoring or co-presenting with several Codoxo customers, including a Special Agent with the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG).

Despite industry slowdowns in many technology sectors, Codoxo continued a strong trajectory of hiring in 2022 byinvesting in additional subject matter experts to build out our domain knowledge and the strategic leadership team. This included the addition of Mark Riendeau to the strategic leadership team. As Vice President of Sales, Mark hit the ground running and in just a short period of time has built a highly proficient sales organization equipped to continue building key partnerships throughout the industry. Additionally, Codoxo grew domain experts across the data science, product engineering, product development, and customer success teams.

Looking to a Brighter Future in 2023

At Codoxo, we’re thrilled about the significant growth and succcess that the company achieved last year but even more so about momentum we aim to continue  in the year ahead – and beyond. Together with our customers, employees and industry partners, we’re committed to transforming the healthcare ecosystem whle delivering impact every step of the way.

To learn more about the success we’ve achieved in 2022, checkout our recent press release.

To learn more about Codoxo’s Unified Cost Containment Platform, and how we’re using AI to transform the healthcare payer industry from the ground up, please contact us at