Increased savings: Healthcare payer customers leveraging Codoxo’s AI solutions have realized substantial increases in dollars saved. Average savings per member per year (PMPY) across specialized solutions include:-
- $10 PMPY from Codoxo’s AI-driven provider education solution, Provider Scope
- $5 PMPY from Codoxo’s AI-driven data mining services, Audit Scope
- $2 PMPY from Codoxo’s AI-driven fraud investigations, Fraud Scope
Revealing top causes of fraud, waste, and abuse (FWA): Data analyzed by Codoxo’s healthcare AI solutions have pinpointed the most common instances where U.S. healthcare dollars are misspent. The top three areas are:
- Abuse and misuse of the audio-only telehealth services modifier
- Off-label use of expensive weight loss drugs, particularly Ozempic, Mounjaro, and Wegovy, including collusion and steering schemes
- Genetic testing procedures without health plan policies and limits in place
“Codoxo’s commitment to advancing AI and creating unique cost-saving solutions for healthcare payers continues to fuel its growth. This is evidenced by Codoxo recently signing an agreement with one of the largest insurers in the world and a Fortune 10 company,” stated Dr. Musheer Ahmed, CEO and Founder of Codoxo. “Codoxo’s patented healthcare AI platform identifies incorrect payments exponentially earlier, improves provider billing and coding accuracy, and facilitates previously untapped payer-provider collaboration to eliminate payment friction.”
Additional markers of company momentum for Codoxo in 2024 include:
Launched AI for PI Community: Codoxo launched the AI for PI Community last year, an exclusive community of leaders on LinkedIn who are interested in the application and value of artificial intelligence for healthcare cost containment. AI for PI has grown swiftly, attracting leaders from every major regional payor and state and federal healthcare agency, including 75 group members on LinkedIn.
Hosted the inaugural AI Summit: The newly-launched AI for PI Community hosted its first annual AI Summit in June, with 70 leading payment integrity executives in attendance. Congressman David Schweikert – currently serving his seventh term in the United States Congress – served as keynote speaker for the event. His work as Co-Chair of the Telehealth Caucus proved pivotal in passing flexibilities during the COVID-19 pandemic. Schweikert shared his vision for an AI-powered healthcare system and support for policies that leverage AI technology to drive down expenses, echoing the pressing need for affordability.
About Codoxo
With a mission to make healthcare more affordable and effective for everyone, Codoxo is the premier provider of generative AI and 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 payment integrity, provider coding and billing, special investigation unit (SIU), network management, and clinical teams. 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 for growth. Our solutions are HIPAA-compliant and operate in a HITRUST-certified environment. For additional information, visit https://www.codoxo.com/.
About the AI for PI Community
The AI for PI Community brings together healthcare payment integrity professionals to learn about and accelerate the adoption of artificial intelligence technologies and solutions that collectively and actionably reduce the rising cost of care. Through education, networking, and shared best practices and use cases, AI for PI aims to inform and inspire thousands of healthcare payer, government agency, and pharmacy benefit manager (PBM) teams seeking innovative “shift-left” strategies that safeguard their bottom lines and contribute to a less costly U.S. healthcare system.Anyone who works in the payment integrity industry can join the community by visiting https://aiforpaymentintegrity.com/join.
Media Contact
Ronda Duncan, Codoxo, 8472549782, [email protected], https://www.codoxo.com
SOURCE Codoxo
