Deepfake Detection
Identify AI-Generated Medical Fraud Before It Costs You Millions
Detect Documentation Fraud Traditional Systems Cannot See
Healthcare payers have always faced documentation inaccuracies. But generative AI has introduced an entirely new category of threat: highly convincing fraudulent medical documentation, fabricated at scale, that rules-based systems were never built to detect.
Studies show that only 68% of people who aren’t warned about deepfakes can spot one — and when warned, only 34% can reliably identify them. Manual review is no longer a viable defense.
Codoxo’s Deepfake Detection equips SIU and Payment Integrity teams with AI that fights AI. The solution analyzes medical records, clinical notes, and diagnostic images for signs of AI generation, manipulation, or cloning — surfacing risk that legacy systems miss and enabling teams to intervene before a single fraudulent payment is made.
Ready to Spot Fraud That Looks Legitimate?
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Detect What Traditional Controls Cannot See.
Deepfake Detection applies advanced AI models to analyze medical documentation, diagnostic images, and supporting claim materials for signs of AI generation, manipulation, or duplication.
As documentation enters SIU or Payment Integrity workflows, the system:
- Detects fully AI-generated clinical notes, therapy records, and medical necessity documentation
- Identifies blended and partially AI-generated records — the most sophisticated schemes, where authentic content is combined with fabricated sections
- Flags cloned or duplicated documentation and diagnostic images reused across multiple patients
- Cross-references documentation against claim history and provider behavior for broader pattern detection
- Assigns a 0–100 intelligent risk score with detailed, explainable indicators for fast investigator action
Continuous adaptive learning ensures detection models evolve as generative AI techniques advance, so protection keeps pace with emerging fraud tactics.
AI Is Moving Fast. Your Detection Needs to Move Faster.
Catch fraud traditional systems miss
AI-generated documentation is engineered to look legitimate. Deepfake Detection identifies forged records, fabricated clinical notes, cloned diagnostic images, and blended documents — the fraud that rules-based controls are blind to
Intervene before payment
Detection embedded directly in pre-pay and SIU workflows means risk is surfaced before funds leave the organization — not discovered during costly post-payment recovery
Accelerate case reviews and reduce investigation time
Generative AI automates time-consuming manual document reviews, surfacing relevant fraud indicators faster so SIU teams can close more cases with the same resources
Prioritize high-risk cases with confidence
Automated 0–100 risk scoring with detailed explanations helps teams focus resources on the most impactful investigations and recover more effectively
Strengthen recovery cases with defensible evidence
AI-generated evidence and detailed fraud indicators give SIU teams compelling, explainable documentation to support overpayment recovery and dispute resolution
Adapt to your unique fraud patterns
Configurable risk thresholds, customizable prompts, and continuous adaptive learning let you tailor detection to your organization’s specific fraud environment as tactics evolve
Explore Codoxo’s Full Solutions Offerings
The Difference Detection Makes
Reduced financial exposure
Smarter Healthcare Cost Containment Starts With Codoxo
Codoxo’s solutions are delivered through our 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 enhanced operational efficiency. By transforming the landscape of healthcare cost containment and payment integrity with industry-leading AI, Codoxo is at the forefront of making healthcare more affordable and effective.
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