AI Solutions for Healthcare

Codoxo’s Forensic AI Platform Named Fierce Healthcare Innovation Award Winner in the “Data Analytics/Business Intelligence” Category

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Codoxo’s Forensic AI Platform Named Fierce Healthcare Innovation Award Winner in the “Data Analytics/Business Intelligence” Category

Patented Self-learning Healthcare AI Recognized for Effectiveness, Technical Innovation, Competitive Advantage, and Financial Impact for Healthcare Payers, Agencies and PBMs

ATLANTA (November 15, 2022) – Codoxo, a trusted provider of healthcare artificial intelligence (AI)
solutions for healthcare payers and agencies, announces that it is the winner of the 2022 Fierce Healthcare Innovation Award in the “Data Analytics/Business Intelligence” category. Winners were judged by a panel of executive leaders from organizations throughout the healthcare ecosystem on their ability to “demonstrate effectiveness, technical innovation, competitive advantage, financial impact, and true innovation.”

Codoxo’s patented Forensic AI Platform supports healthcare cost containment and payment integrity for healthcare payers, agencies, and PBMs. It predicts and identifies fraud, waste, and abuse (FWA) schemes among millions of healthcare claims before hitting the bottom line of healthcare organizations, who find it increasingly difficult to distinguish between appropriate care, simple coding mistakes, and intentional fraud. This problem is compounded by their use of rules-based FWA tools that cannot keep up with quickly evolving coding and error trends, schemes, and bad actors resulting in billions of dollars lost to FWA in the U.S. healthcare system every year.

The Forensic AI Platform is recognized for its self-learning AI that analyzes healthcare claims data, detects practices that intentionally or unintentionally waste money, and builds connections across data to provide actionable insights.

The industry-leading platform uses academic, research-based AI, proven to help maximize savings and help health plans, agencies and PBMS in a variety of ways, including: 

    • Collaborate efficiently across SIU, Payment Integrity, Clinical and Network teams to create a unified view of cost containment within a single platform
    • Automate audit workflows and digitize medical record retrieval process to request and retrieve records electronically
    • Shift ‘further left’ from pre-pay by influencing future claims pre-submission through proactive provider education
    • Perform impactful cross-claim analysis across professional, facility, pharmacy and dental claims
    • Enable an integrated approach to track savings across post-pay, pre-pay and pre- claim submission

“Our goal from day one has been to use the most innovative AI available to disrupt the U.S. healthcare system and drive down healthcare costs impacted by fraud, waste, abuse, and error,” stated Dr. Musheer Ahmed, Codoxo’s Chief Executive Officer and Founder. “We are honored to have our hard work and transformational technology recognized by the Fierce Healthcare Innovation Awards, and we look forward to continuing to expand its use among healthcare organizations in our effort to strive toward healthcare affordability and effectiveness.” 

According to Rebecca Willumson, SVP & Publisher of Fierce Biotech and Fierce Pharma, “Winners of the Fierce Innovation Awards represent those that champion innovation in the face of great competition.”

Codoxo is joined by Vital Data Technology, PointClickCare, and Rhino Health in the 2022 Fierce Healthcare Innovation Award finalist shortlist. Codoxo also was a 2021 Fierce Healthcare Innovation Award finalist. 

To learn more about Codoxo and its award-winning Healthcare Integrity Suite of solutions and its Forensic AI Platform, please visit our website.

About Codoxo
Codoxo’s mission is to make healthcare more affordable and effective for everyone and serves as 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. The Codoxo Unified Cost Containment Platform helps clients manage costs across network management, clinical care, provider coding and billing, program 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. Our solutions are HIPAA-compliant and operate in a HITRUST-certified environment. For additional information, visit www.codoxo.com.

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 >