AI Solutions for Healthcare

In May 2022, KLAS Research published an Emerging Technologies Report featuring Codoxo and its Fraud Scope solution, in an effort to showcase our ability to deliver AI and help ensure payment integrity for healthcare payers. This report comes at a time when healthcare spending is inflating and billions of dollars are put toward healthcare each year, yet much of it is lost to fraudulent claims and bad payments. To help payer organizations control costs, KLAS featured Codoxo’s Forensic AI Platform within the report to share with the industry ways in which it can provide actionable insights that identify existing or emerging fraud, waste, and abuse (FWA) issues and looks to validate the Codoxo customer experience.  

The feedback from Codoxo’s customers was powerful. 

Good partnership, communication, and support 

“When we have given the vendor feedback, they have always incorporated our feedback into the solution. They are great about that, and we are pleased with them. Codoxo does a great job of communicating with their clients, and we really appreciate the business relationship that we have with them. When we speak to the vendor’s people, they listen.” —VP/director  

AI functionality drives outcomes  

“Part of the reason we were really excited about the platform was the rate at which it identifies new issues. It reduces the time lag between scheme emergences and catches up with rules-based updates. I have seen that trend happen without human interaction. So, we are hopeful that the timeline will work for us in the future.” —VP/director  

Vendor keeps all promises  

“The vendor has kept their promises, and they have been very good to work with. The vendor has done what we have asked them to do.” —Director  

Additionally, KLAS rated Codoxo with an “A” for executive involvement and “A+” for how likely our customers are to recommend Fraud Scope to other payers. The report also indicated 100% of our customers would buy again.  

“AI solutions that manage FWA and drive higher levels of payment integrity will become foundational for all payer organizations. When AI solutions like Codoxo’s are frequently trained and fine-tuned, they continually evolve to increase protection and value in delivering risk stratification and management.” —Mike Davis, HCIT market research and analysis expert, KLAS Research

Our solution not only proved more effective as a standalone platform than a multitude of other tools in detecting high-potential leads, but also helped prioritize leads based on exposure. Fraud Scope is leading the way to a more secure future in healthcare. 

If you are interested in reading the full KLAS report, visit: