AI Solutions for Healthcare

Collaborate. Contain. Codoxo.

Join the movement to protect your limited healthcare dollars with the most powerful, effective AI in the industry.

1 billion

CLAIMS

PROCESSED

$500M

IDENTIFIED

SAVINGS

%

REDUCTION IN

FALSE POSITIVES

%

INCREASE IN

PRODUCTIVITY

It’s time to break the spiraling cost trends of healthcare fraud, waste and abuse. Codoxo’s innovative Healthcare Integrity Suite works across your cost containment spectrum to deliver significant savings and an average 15:1 ROI.

Fueled by a culture of constant innovation and an incessant drive to ensure client success, our team of collaborators are here to help you disrupt the status quo. Every healthcare payer or agency is unique; we will work with you to identify and meet your specific needs and deliver next-level outcomes.

Join the movement.

Our customers drive savings across payment integrity, SIU, network and clinical teams. We help some of the largest plans and agencies in the country identify opportunities to control costs.

Highmark

6+ million members

Highmark identifies millions in new active cases with AI-powered provider analysis from Codoxo

READ CASE STUDY >

Pacific Health Plan

1.5+ million recipients

AI helped Program Integrity Unit at State Medicaid Agency realize a 1,500% ROI

READ CASE STUDY >

Pacific Health Plan

3.5+ million members

Large plan protects public health funds by proactively identifying ways to control healthcare costs with Codoxo

Pacific Health Plan

700+ thousand members

Several departments at this plan use our AI solutions to meet their needs

Pacific Health Plan

2.5+ million members

Ensures fraud and payment integrity teams are using AI to protect the plan

3+ million members

Harvard Pilgrim Health Care embraces artificial intelligence from Codoxo to detect FWA issues

READ CASE STUDY >

Join the movement.

Our customers drive savings across payment integrity, SIU, network and clinical teams. We help some of the largest plans and agencies in the country identify opportunities to control costs.

Highmark

6+ million members

Highmark identifies millions in new active cases with AI-powered provider analysis from Codoxo

READ CASE STUDY >

Pacific Health Plan

1.5+ million recipients

AI helped Program Integrity Unit at State Medicaid Agency realize a 1,500% ROI

READ CASE STUDY >

Pacific Health Plan

3.5+ million members

Large plan protects public health funds by proactively identifying ways to control healthcare costs with Codoxo

Pacific Health Plan

700+ thousand members

Several departments at this plan use our AI solutions to meet their needs

Pacific Health Plan

2.5+ million members

Ensures fraud and payment integrity teams are using AI to protect the plan

3+ million members

Harvard Pilgrim Health Care embraces artificial intelligence from Codoxo to detect FWA issues

READ CASE STUDY >

– Brian Robinson, Director of Special Investigations Units
HARVARD PILGRIM HEALTH CARE

– Brian Robinson,
Director of Special Investigations Units
HARVARD PILGRIM HEALTH CARE

FORENSIC AI PLATFORM

Our Forensic AI Engine analyzes your data, detects problems, and builds connections across your data to provide actionable insights

Insight Scope

For everyone across the health plan

Clinical Scope

For clinical teams

Network Scope

For network teams

Payment Scope

For payment integrity teams

Provider Scope

For network and payment teams

Fraud Scope

For SIU teams

SERVICES

We provide a full range of professional services, from data migration and ongoing customer success through flexible virtual SIU options.

Fraudscope is now Codoxo. LEARN MORE >