AI Solutions for Healthcare

Codoxo to Showcase Generative AI Innovations for Zero-Touch Payment Integrity at 2024 HPRI Congress South


Codoxo to Showcase Generative AI Innovations for Zero-Touch Payment Integrity at 2024 HPRI Congress South

Healthcare AI software company will demonstrate how its health plan partners are using new tools to realize significant pre-pay cost avoidance

DULUTH, GA. (February 1, 2024) – Codoxo, a trusted provider of healthcare artificial intelligence solutions for healthcare payers, agencies and pharmacy benefits managers (PBMs), today announced it will present live at the second annual Healthcare Payment and Revenue Integrity (HPRI) Congress South on Thursday, February 8, at 12:45 p.m. Eastern Time at the Miami Beach Convention Center in Miami, Florida. 

At the conference, Gold Partner Codoxo will join leaders in payment and revenue integrity and revenue cycle management to discuss the use of AI and generative AI solutions to move toward zero-touch payment integrity and improved cost containment. .

Jesse Montgomery, VP of Analytics and Data Science at Codoxo, and Rena Bielinski, VP of Customer Success at Codoxo, will co-present a use case titled “AI-Driven Provider Education Saving Millions for Payers.” They will jointly demonstrate how health plans can realize cost avoidance savings of $4.00-$7.00 PMPY (per member per year) by adopting proactive AI-based provider education, including a provider self-monitoring portal. This has the potential to translate to $2M-$3.5M in cost avoidance annually for a mid-size health plan with 500k members.

“As the payment integrity industry continues to ‘shift left’ through pre-claim submission efforts, executives are looking for AI-driven tools to maximize coding accuracy and increase savings,” stated Dr. Musheer Ahmed, Codoxo’s Chief Executive Officer and founder. “Automation, including generative AI, can help health plans address resource constraints, identify previously undetectable emerging coding issues, and strengthen collaboration with their provider network. At HPRI Congress South we will showcase our generative AI solutions for payment integrity and share how we are helping to move the needle on efficiency and savings for healthcare payers.”

Provider Scope to be Showcased in Booth #7

Codoxo invites attendees to learn about its Provider Scope offering, as well as the rest of our AI-based cost containment solutions in Booth #7. Provider Scope is built on Codoxo’s Forensic AI Engine and is used by provider education and network teams at healthcare companies because of its ability to help bring down costs pre-claim with unique provider and facility insights. Provider Scope uses a self-monitoring and communication portal to compare provider claims and coding practices to peers, identifies outlier behavior, and proactively engages providers to improve claim integrity. The technology enables payers and healthcare companies to efficiently reduce coding errors and influence healthcare costs prior to submission of claims, decreasing provider abrasion.

About Codoxo

With a mission to make healthcare more affordable and effective for everyone, Codoxo is the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud, waste, and abuse and ensure payment integrity. The Codoxo Unified Cost Containment Platform helps clients manage costs across network management, clinical care, provider coding and billing, payment integrity, and special investigation units. Our software-as-a-service applications are built on our proven Forensic AI Engine, which uses patented AI-based technology to identify problems and suspicious behavior far faster and earlier than traditional techniques. Codoxo is a Fierce Healthcare Innovation Award winner and has been recognized by the Inc. 5000 list of fastest growing companies in America. Our solutions are HIPAA-compliant and operate in a HITRUST-certified environment. For additional information, visit