Generative AI-Powered Solutions for Early Payment Integrity Intervention

Pioneer the future of healthcare cost containment with Codoxo’s generative AI solutions – where provider abrasion is minimized, savings are optimized, and recoveries are maximized.

Codoxo’s cost containment solutions strengthen payment integrity programs by identifying and addressing issues early in the process.

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Discover the Power of Early Intervention.

Move Your Payment Integrity & Cost Containment Programs Upstream

It’s hard to ignore the urgent push towards shifting payment integrity earlier in the payment cycle and creating stronger relationships with providers – all while reducing healthcare costs.

Codoxo’s generative AI-powered solutions enable healthcare payers, government agencies, and pharmacy benefit managers to take a proactive approach to healthcare payment accuracy. By combining early provider education with comprehensive prepay and postpay solutions, Codoxo helps optimize savings and maximize recoveries across the entire payment spectrum.

Built on our award-winning Unified Cost Containment platform, these pioneering AI and gen AI solutions protect your bottom line – with unparalleled speed and accuracy – while fostering a smarter, more sustainable healthcare system.

    “Improving payer-provider communication can reduce disputes by 25% and significantly accelerate claims resolution.”

    Bridging the payer-provider divide | HFMA

    Manage Improved Payment Integrity Outcomes With Ease & Confidence

    Embrace a seismic shift left

    Stop financial loss pre-claim with more accurate healthcare payments

    Analyze all claim types

    Professional, facility, pharmacy, behavioral, dental, and workers comp – to create connections across data and identify patterns at every level, from individual claims and providers up through groups, networks, and plans

    Empower stakeholders & teams

    Operate at the top of their licenses and focus on higher-value tasks

    Boost automation, streamline workflows, & enhance process efficiency

    Gen AI technology reduces manual labor and identifies schemes with greater speed and accuracy

    Strengthen healthcare compliance

    AI-powered auditing ensures accurate documentation, maintains regulatory standards, and provides clear audit trails for all audits

    Trust best-in-class security

    Codoxo’s security standards will protect your data at the highest levels industry-wide

    Not All AI-Driven Solutions for Payment Integrity Are Created Equal

    $1B+
    identified savings

    $60 PMPY

    in cost reduction throughout your entire cost containment journey

    20x-30x

    improvement in resource efficiency

    80-90% average

    increase in productivity

    99% reduction

    in payment errors, improving accuracy and reducing manual intervention

    Smarter Healthcare Cost Containment
    Starts With Codoxo

    Codoxo’s products, services, and 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 healthcare 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.

    Explore Codoxo’s Unified Cost Containment Platform
    Products & Services

    One platform for complete prepayment and postpayment cost containment in healthcare
    Provider Scope
    Bring down costs pre-claim with proactive and automated provider education.

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    Audit Scope
    Automate and streamline end-to-end audit detection and workflow while ensuring compliance.

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    Fraud Scope
    Automatically and accurately detect new and emerging fraud schemes, streamline evidence chain collections, and integrate workflows for FWA investigations.

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    Payment Scope
    Identify claim accuracy issues before claims are paid with unique claim insights, easy-to-use claim workflow, and automated provider outreach.

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    Clinical ClaimPilot
    Automate medical record reviews with generative AI, speeding up reviews and increasing audit accuracy.

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    Compliance ClaimPilot
    Validate provider contracts and medical policies to ensure payment accuracy and reduce manual errors.

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    Concept Claimpilot
    Accelerate concept development of new claim payment methods and proactively spot payment gaps with generative AI.

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    Medical Record Reviews Services
    Speed turnaround times and increase accuracy for in-patient, facility, and DRG audits with generative AI-driven medical record reviews services.

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    Data Mining Services
    Uncover more overpayments with AI-driven outsourced healthcare data mining services.

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    Virtual SIU Services
    Offload SIU compliance and scale operations through end-to-end virtual resources and services.

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    Ready to Transform Your Healthcare Cost Containment?