AI Solutions for Healthcare

Professional Services

We provide a full set of services to our customers that enhance and augment your experience with Codoxo. Our expedient data integration and professional support team help you get up and running quickly. Combining all of this with our customer success and virtual SIU services helps you maximize your partnership with Codoxo.

Data Migration

Worried about getting your data ready for AI analysis? Our Data Engineers are available to help get your data prepped and loaded into Codoxo. Most customers are up and running in just a few weeks.

Customer Success

We take a proactive approach to helping our customers, with everything from ongoing support, strategy discussions, timely enhancements and regular releases of new industry queries that help your teams stay one step ahead of emerging fraud schemes.

Customer Support

We know how important it is to speak with someone live, so customers can contact Codoxo customer support by phone or email Monday thru Friday.

(470) 223-3591
support@codoxo.com

Virtual SIU services

Our virtual SIU team includes experienced investigators with a proven track record of prior investigative, law enforcement and healthcare expertise. Our team is available to augment your team using Codoxo.

Lead generation designed to achieve the highest level of ROI

Our experienced analysts can be an extension of your SIU and work in the platform to assist with lead generation, lead analysis for those leads generated by our customers, as well as ongoing sharing of best practices based on all customer findings and identification. For example, we created specific sets of queries related to COVID (that include updated codes, lab testing, telehealth), which are deployed and frequently updated to all Codoxo customers as part of our value-add experience.  

Medical record review

Experienced and credentialed services including RN, LPN, CPC and CPhT. 

Advisory support and leadership expertise

FWA strategy assistance in a COVID & post-COVID environment. 

Virtual SIU

Extending your team’s FWA investigations is a great way to increase bandwidth, focus on qualified cases, and recover more of the costs lost to fraud. Our experienced investigators utilize accepted methodologies for collecting, evaluating and reporting investigative information and evidence. Your virtual SIU experts will  prepare factual chronological summaries of collected evidence and data on providers/subjects in support of complex and lengthy investigations and cases. 

Flexible service and delivery models

We work with customers to tailor our SIU services to meet your needs. Whether you need full-staff augmentation, just a few hours a month for consultations with an expert investigator, or something in between, just contact us and we’ll work with you to figure out the best fit.

1 billion

Claims processed
by AI

$500M

Identified savings
by Codoxo

%

Reduction in false positives

%

Increase in productivity

"Codoxo's Forensic AI Platform is a game changer.
AI is helping us identify, prevent, and stop potentially fraudulent activities earlier than ever.”
Highmark

– Kurt Spear, Vice President Financial Investigations and Provider Review

Saving millions at world-class insurance companies and healthcare agencies including:

State Medicaid Agency

2+ million recipients

Southeast Blue Plan

3+ million members

Midwest Blue Plan

2.9 million members

Pacific Health Plan

700K+ members

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

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 >