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Principal Care Management and Chronic Care Management Billing for Members with Autism: Data Indicators and Investigative Considerations
Overview Principal Care Management (PCM) and Chronic Care Management (CCM) are monthly care management services that...
Detecting Deepfake Medical Documentation Without Added Operational Burden: A Practical Guide for Healthcare SIU Leaders on Implementing an Effective Validation Layer
As generative AI becomes more deeply embedded in healthcare workflows, organizations are increasingly recognizing...
Remote Patient Monitoring: Historical Growth, Coding Complexity, and Risk
Remote Patient Monitoring (“RPM”) has become one of the most visible examples of technology-enabled care delivery in...
The 3 Types of AI-Generated Medical Fraud Every SIU Should Be Able to Detect
Healthcare fraud is evolving – and in some cases, it’s no longer visible in the ways payment integrity teams expect....
Unbundled Billing: Understanding Hidden Costs in Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Reimbursement
Rising Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) expenditures and utilization continue...
Putting Pressure on Skin Substitutes
What are skin substitutes? A skin substitute is a product that is engineered from human, animal or synthetic materials...
Codoxo and Optum Serve Partner to Strengthen Payment Integrity Across Federal Health Programs
A New Approach to an Old Problem Federal health programs face a persistent and growing challenge: how to safeguard...
Codoxo’s 2025 Forensic AI Alerts Reveal Where Payment Integrity Risk Is Headed in 2026
Throughout 2025, payment integrity teams faced a steady stream of new billing behaviors, emerging fraud patterns, and...
Payment Integrity is at an Inflection Point: What 2025 Revealed — and What 2026 Demands
As healthcare organizations closed the books on 2025, one reality became unmistakable: payment integrity has reached...
When it comes to laboratory referral fraud, how can your plan leverage GenAI to uncover old tricks?
Unsupported laboratory services linked to various referral patterns and inappropriate business relationships remain...
A Breakout Year for Codoxo and the Next Era of Payment Integrity
By Musheer Ahmed, PhD, Founder & CEO, Codoxo Over the past year, I’ve engaged in numerous discussions with health...
Deepfake Detection in Healthcare: Understanding the Risk and New Tools to Fight It
Healthcare fraud has always evolved rapidly, but never this fast. Deepfake fraud is no longer a theoretical risk or a...
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