Jesse Montgomery, vice president of analytics and data science at Codoxo, and Rena Bielinski, vice president of customer success at Codoxo, will co-present a use case titled “Supplier education based on AI Saves Payers Millions.” They will jointly demonstrate how health plans can save money by avoiding costs $4.00–$7.00 PMPY (per member per year) by adopting proactive AI-based provider training, including a provider self-monitoring portal. This has the potential to result in 2 million dollars–$3.5 million in terms of cost avoidance each year for a mid-sized health plan with 500k members.
“As the payment integrity industry continues to ‘shift left’ with pre-claims submission efforts, executives are looking for AI-powered tools to maximize coding accuracy and increase savings” , said Dr. Musheer Ahmed, CEO and founder of Codoxo. “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 help advance efficiencies and savings for healthcare payers.
Scope of the supplier which will be presented on stand no. 7:
Codoxo invites attendees to learn more about its Provider Scope offering, as well as the rest of our AI-based cost containment solutions at booth #7. Provider Scope is built on Codoxo’s Forensic AI Engine and is used by healthcare company provider training and network teams due to its ability to reduce pre-claims costs with unique insights into providers and establishments. Provider Scope uses a self-monitoring and reporting portal to compare providers’ claims and coding practices to those of their peers, identifies aberrant behavior, and proactively engages providers to improve claims integrity. The technology allows payers and healthcare companies to effectively reduce coding errors and influence healthcare costs before claims submission, thereby reducing provider abrasion.
About Codoxo
With a mission to make healthcare more affordable and effective for everyone, Codoxo is the leading provider of artificial intelligence-based solutions and services that help healthcare companies and agencies detect and reduce proactively the risks linked to fraud, waste and abuse and ensure payment integrity. Codoxo’s unified cost containment platform helps customers manage costs in the areas of network management, clinical care, provider coding and billing, payment integrity and survey units special. Our Software-as-a-Service applications are powered by our proven Forensic AI Engine, which uses patented AI-based technology to identify issues and suspicious behavior much faster and earlier than traditional techniques. Codoxo is a winner of the Fierce Healthcare Innovation Award and has been recognized by the Inc. 5000 list of America’s Fastest Growing Companies. Our solutions are HIPAA compliant and operate in a HITRUST certified environment. For more information, visit http://www.codoxo.com.
Media contact
Ronda DuncanCodoxo, 8472549782, (email protected), https://www.codoxo.com
SOURCE Codoxo
