AI Solutions for Healthcare

Our focus on putting the customers’ needs first is what makes us so effective

by Missy Swann, Client Engagement Manager

At Codoxo, our customers are the driving force behind everything we do, and we believe they know it. It’s among the reasons for our rapid growth and our ability to disrupt healthcare cost containment as a young company.

Our AI is transforming our customers’ ability to detect fraud, waste, and abuse quickly and accurately. But providing an AI platform, as effective as it is, isn’t enough. To us, it’s critical to build relationships with our customers and offer expert guidance on how to do things better. We want to empower customers to be transformative and to look to innovative partners, solutions, and technologies to help them contain costs and proactively manage fraud, waste, and abuse.

I think J.R. Trevino, a manager in the Special Investigations Unit at Driscoll Health Plan, said it best:

“With Codoxo, we have a true partnership and collaboration for the common good.”

That’s the core of what we do: work with customers every step of the way because that’s what it takes to positively change the healthcare industry.

Putting customer needs first

As Codoxo’s client engagement manager, I’m charged with onboarding new clients and setting them up for success with our platform. I ensure smooth implementations while drawing from my many years of experience in general and project management with health plans and other agencies.

I serve as the liaison between our talented technical teams who run product development and the frontline customer success professionals who interface with our clients every day. I make it a priority to ensure every customer question is answered, and that our clients receive first-class guidance and support.

Customer questions provide great value to our company, as we use them to drive innovation. Questions, comments, suggestions – all the different customer perspectives we receive – are used to shape our roadmap. That’s how we know the solutions we create meet customer needs.

The value of listening

We understand that while the processes we employ must be repeatable, they also must be customizable. Leadership in every organization we partner with has different needs and challenges they must overcome. No two clients are identical, so a one size fits all approach simply doesn’t work.

How do we meet those varying customer needs? It’s simple. We listen. We ask questions. We learn about their business, their challenges and their concerns. We talk with them about the claims systems they’re using, for example, and the various policies they have in place. We share best practices. Then we tailor an approach to get them the results they’re after.

Regular check-ins are vital to this process. Client forums are another way we build and maintain connections. We’re constantly engaging with our clients to ensure we’re giving them a cost containment solution that’s tailored to their organization.

Small but mighty

In a short amount of time, Codoxo has made a significant impact in a space that’s always been occupied by giant corporations. It’s a testament to our commitment to putting the customer first and to our ability to innovate. We not only offer advanced cost-containment solutions that improve results, but we also embrace the role of a trusted partner. Essentially, we build long-lasting relationships.

Our partner at Highmark stated, “Codoxo’s forensic AI platform is a game-changer. AI is helping us identify, prevent, and stop potentially fraudulent activities earlier than ever.” Kurt Spear, Vice President Financial Investigations and Provider Review, Highmark, Inc.

Our AI solutions fill a void in the market—and our competitors have taken notice. That speaks volumes about our platform and what it brings to payment integrity. And the fact we’re smaller gives us an advantage. We’re able to be more nimble and innovate faster because we’re not bogged down by “the process.” There’s no red tape, just talented people collaborating to bring to market a cost containment solution that truly makes a difference in preventing fraud, waste, and abuse, and safeguarding payment integrity.

A commitment to getting it right

Pushing the boundaries of what’s possible is central to who we are as a company. In my role, it’s important to stay curious and constantly ask the right questions at the right time. If I don’t keep an open mind, I might miss something that will make the difference in a customer’s success. It’s my responsibility to consider all the possibilities while looking for better approaches to solving challenging problems. It’s that curiosity that leads to truly remarkable solutions for our clients.

A true collaborative effort

The Codoxo team is innovative, collaborative and consists of people excelling at what they do. Successful innovation stems from working together. We must collaborate across the business, and we look for ways to motivate our customers to do the same. We understand that everyone is working toward the imperative goal of reducing costs in the healthcare industry and returning meaningful savings to our customers.

With every product we develop and every decision we make, we remain laser-focused on our customers. We strive to develop solutions that enable them to make a positive impact, uncovering fraud schemes or errors that might have otherwise gone undetected. Codoxo’s culture of innovation, collaboration, and customer- centricity is what makes that possible.

View our recent video to learn more about Codoxo’s mission and our movement.

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

Audit Scope

For everyone across the health plan and PBM

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.