A Better Approach to Payment Integrity
Introducing Payment Integrity Solutions Designed for the Earliest Intervention
Designed to seamlessly integrate across pre- and postpayment, our solutions will protect both your provider relationships and your bottom line.
Codoxo’s Payment Integrity solutions focus on early intervention and education, resolving potential issues before claims are created. By shifting reviews to pre-claim submissions and prepayment, these solutions help healthcare payers avoid overpayments, reduce the need for costly recovery efforts, and ensure compliance with contracts and regulatory standards.
Ready to strengthen payment integrity outcomes without creating provider abrasion?
Seamlessly Integrate Pre- & Postpayment Integrity With a Single Vendor
Codoxo stands alone as the only vendor offering a comprehensive suite of payment integrity solutions that delivers unparalleled value across the entire payment lifecycle. Unlike traditional payment integrity solutions that focus narrowly on reactive interventions, Codoxo’s platform leverages generative AI and advanced automation to intervene as early as possible in the payment process — starting with proactive concept ideation.
- Concept development
- Provider policy alerts & compliance
- Provider education for coding & billing accuracy
- Provider contract compliance
- Medical record reviews
- Audit management, tracking & reporting
- Data mining
Our Approach is Unique – Specializing in the Earliest Intervention for Cost Avoidance & Better Provider Experiences
Strengthen provider relationships
Through proactive and early education to providers, accurate claims are submitted, processed and paid, avoiding traditional abrasive payment integrity intervention
Reduce payment denials
Address errors before claims are created, to avoid payment denials that often trigger time-consuming and expensive processes such as appeals, resubmissions, and manual reviews
Reduce administrative costs & improve MLR
By reducing denials, health plans minimize these administrative expenses, which count as non-medical costs
Enhance claim accuracy
Improved prepayment processes, such as AI-driven claim reviews and provider education, reduce overpayments, and payment errors
Explore Codoxo’s Full Solutions Offerings
Transformative Results with Codoxo
$8-12 PMPY
700%
more daily claim audits with turnaround times under 24 hours
Smarter Healthcare Cost Containment Starts With Codoxo
Codoxo’s payment integrity 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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