AI Solutions for Healthcare

Knowledge is power, and when it comes to cost containment education, healthcare executives are craving it. A recent survey shows that three-quarters of healthcare executives say that cost containment is a high priority for them in 2022. In fact, more than a third (37%) say it’s their top focus.

Codoxo is disrupting the status quo of rising healthcare costs while providing continuous learning opportunities to our community of payment integrity and FWA experts. One highly impactful way we do this is through our monthly Forensic AI Alerts.

Empowering Healthcare Leaders to Prepare for a Better Tomorrow

Healthcare is ever-changing, and the industry needs a trusted source to wade through the sea of updates, data mandates, coding changes, and trends to share the most important information with actionable recommendations. Enter Coxodo’s Forensic AI Alerts.

Each month, our experienced team of payment integrity and FWA experts gather time-sensitive updates you need to know in Forensic AI Alerts, which are designed to share opportunities to impact cost containment and uncover areas across FWA and payment integrity causing risk within healthcare organizations.

Our Forensic AI Alerts offer the latest trends, industry updates, best practices and specific steps on how to act quickly to achieve cost savings and avoid impacts to the bottom line. They cover timely topics such as:

      • New and timely schemes to watch out for
      • Code updates – procedure, diagnosis, evaluation
      • Coverage criteria updates
      • Supplemental references

We kicked off the calendar year by diving into the specialized treatment of Hyperbaric Oxygen Therapy (HBOT). In addition to gaining a better understanding of HBOTs, our community also learned about procedure codes, common FWA-related schemes, Medicare coverage criteria, diagnosis codes, and more. With each alert, we educate the reader, but importantly  — we guide readers on how to use that information effectively in everyday practice.

“Our Forensic AI Alerts allow us to consistently share recommendations on topics that health plans are craving more knowledge about, but find challenging to track and monitor themselves,” said Rena Bielinski, PharmD, AHFI, Codoxo VP of Customer Success. “We’re dedicated to finding ways to help our customers every day.”

COVID-19 created questions, we provided answers

Over the past two years, the industry demanded information and greater knowledge around the global pandemic. We have — and continue to — support that demand. It was an uncertain time, but through our team and Forensic AI Alerts, we have helped ease the concern across many emerging areas of COVID-19, including:

      • Vaccination status diagnosis codes
      • Latest testing guidelines
      • Vaccine and administration codes
      • Post COVID-19
      • Telehealth

In May, we shared important coding changes made by the Centers for Medicare and Medicaid Services (CMS) when it comes to The Place of Service (POS) code set. In addition to sharing these revisions, Codoxo also included areas of interest in these coding changes, as well as things to monitor moving forward.

Explore the latest opportunities to impact cost containment

Browse the top topics we’ve covered so far this year with our monthly Forensic AI Alerts:

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.

Fraudscope is now Codoxo. LEARN MORE >