Unified Cost Containment Platform

JSON twin: https://www.healthaidb.com/software/unified-cost-containment-platform.json

Company Name

Codoxo

Product URL

https://www.codoxo.com/products

Company URL

https://www.codoxo.com

Categories

• clinical Care
• administrative Operations
• diagnostic Support
• patient Facing
• payment Solutions
• financial Analytics
• clinical Education
• security
• audit Management
• network Management
• Clinical
• Administrative
• Diagnostic
• Payment Integrity
• Cost Containment
• Provider Education
• Fraud Detection

Summary

Codoxo's Unified Cost Containment Platform leverages AI to proactively identify and address payment issues in healthcare, enhancing cost containment and provider collaboration.

Description

Codoxo's Unified Cost Containment Platform utilizes generative AI and advanced automation to shift payment integrity programs upstream, enabling earlier intervention, proactive cost avoidance, and stronger provider relationships. It unifies data and teams across pre-claim, prepay, and postpay activities, including provider education, payment integrity, special investigation units (SIU), and network management. The platform analyzes diverse claim types—professional, facility, pharmacy, behavioral, dental, vision, and workers’ compensation—to swiftly detect issues and deliver actionable insights. Additionally, Codoxo offers outsourced virtual services such as claims audits, medical record reviews, and end-to-end SIU services. The platform is HIPAA-compliant and operates in a HITRUST-certified environment. ([codoxo.com](https://www.codoxo.com/forensic-ai-platform/?utm_source=openai))

Api Available

unknown

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO
• HITRUST

Company Founding

2018

Company Offices

• United States
• Canada
• United Kingdom
• Germany
• France
• India
• China
• Japan
• Australia
• Brazil

Compliance

• HIPAA
• HITECH
• SOC 2
• ISO 27001
• NIST 800-53 Revision 5

Customers

• MVP Health Care
• Blue Cross Blue Shield health plans
• State Medicaid Agency Program Integrity Unit

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Unified data views
• Generative and self-learning AI
• Automation at scale
• Intelligent reporting
• Real-time access
• Rapid onboarding
• Pre-claim provider education
• Elimination of abrasive payment integrity activities
• Comprehensive coverage across pre-claim, prepay, and postpay solutions
• Superior ROI with $60+ PMPY in cost savings
• Provider education and network services
• Payment integrity
• Special Investigation Units (SIU)
• Network management
• Clinical claim reviews
• Medical record reviews
• Data mining services
• Virtual SIU services

Id

SW1122

Integration Partners

• HealthEdge

Integrations

• HealthEdge Source

Languages Supported

• English
• Spanish
• French
• German
• Italian
• Portuguese
• Dutch
• Russian
• Chinese
• Japanese
• Korean
• Arabic
• Hindi
• Bengali
• Punjabi
• Gujarati
• Tamil
• Telugu
• Marathi
• Malayalam

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb
• consumer

Optional Modules

• Provider Scope
• Audit Scope
• Fraud Scope
• Payment Scope
• Clinical ClaimPilot
• Compliance ClaimPilot
• Concept ClaimPilot
• Medical Record Reviews Services
• Data Mining Services
• Virtual SIU Services

Os Platforms

• Web

Pricing Details

Tier names, public prices, trial info, or 'contact vendor'

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization

Product Code

SW1122

Product Name

Unified Cost Containment Platform

Ratings

• Fierce Healthcare Innovation Award winner
• Recognized by the Inc. 5000 list for growth
• 2024 Leader in Technology Award in 'Excellence in AI Application' category

Regions Available

• United States
• Canada
• Europe
• Asia
• Australia
• South America
• Africa
• Middle East
• India
• China
• Japan
• South Korea
• Singapore
• Brazil
• Mexico
• Argentina
• Chile
• Colombia
• Peru
• Venezuela

Related Urls

• https://www.inc.com/profile/codoxo
• https://www.prweb.com/releases/codoxo-featured-on-the-2024-inc-5000-list-of-americas-fastest-growing-private-companies-302223129.html
• https://www.prweb.com/releases/codoxo-is-named-the-329th-fastest-growing-company-in-america-by-inc-5000-301901474.html
• https://www.prweb.com/releases/codoxo-launches_full_suite_of_ai_powered_solutions_for_healthcare_companies_and_agencies-869103589.html
• https://www.prweb.com/releases/codoxo_to_showcase_generative_ai_innovations_for_zero_touch_payment_integrity_at_2024_hpri_congress_south-302053671.html
• https://elion.health/products/codoxo

Release Year

2022

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA
• DLP

Specialties

• Payment Integrity
• Provider Education
• Fraud Detection
• Audit Management
• Network Management
• Clinical Cost Containment
• Medical Record Reviews
• Data Mining
• Siu Services
• Healthcare Ai Solutions

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• healthcare payers
• government agencies
• pharmacy benefit managers
• special investigation units
• network managers
• clinical teams
• provider education teams

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• The platform identifies new issues rapidly, reducing the time lag between scheme emergence and detection.
• Codoxo's AI-driven solutions have significantly improved our payment accuracy and operational efficiency.

Version

1.0

Alternatives

See related products

Canonical JSON

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  "company_name": "Codoxo",
  "product_url": "https://www.codoxo.com/products",
  "company_url": "https://www.codoxo.com",
  "related_urls": [
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    "https://www.prweb.com/releases/codoxo-featured-on-the-2024-inc-5000-list-of-americas-fastest-growing-private-companies-302223129.html",
    "https://www.prweb.com/releases/codoxo-is-named-the-329th-fastest-growing-company-in-america-by-inc-5000-301901474.html",
    "https://www.prweb.com/releases/codoxo-launches_full_suite_of_ai_powered_solutions_for_healthcare_companies_and_agencies-869103589.html",
    "https://www.prweb.com/releases/codoxo_to_showcase_generative_ai_innovations_for_zero_touch_payment_integrity_at_2024_hpri_congress_south-302053671.html",
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  "product_code": "SW1122",
  "summary": "Codoxo's Unified Cost Containment Platform leverages AI to proactively identify and address payment issues in healthcare, enhancing cost containment and provider collaboration.",
  "description": "Codoxo's Unified Cost Containment Platform utilizes generative AI and advanced automation to shift payment integrity programs upstream, enabling earlier intervention, proactive cost avoidance, and stronger provider relationships. It unifies data and teams across pre-claim, prepay, and postpay activities, including provider education, payment integrity, special investigation units (SIU), and network management. The platform analyzes diverse claim types—professional, facility, pharmacy, behavioral, dental, vision, and workers’ compensation—to swiftly detect issues and deliver actionable insights. Additionally, Codoxo offers outsourced virtual services such as claims audits, medical record reviews, and end-to-end SIU services. The platform is HIPAA-compliant and operates in a HITRUST-certified environment. ([codoxo.com](https://www.codoxo.com/forensic-ai-platform/?utm_source=openai))",
  "categories": [
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    "Network Management"
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  "market_segment": [
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    "Siu Services",
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    "Australia",
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    "Africa",
    "Middle East",
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    "China",
    "Japan",
    "South Korea",
    "Singapore",
    "Brazil",
    "Mexico",
    "Argentina",
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    "Peru",
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    "Korean",
    "Arabic",
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  "license": "commercial",
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    "Germany",
    "France",
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  "company_founding": "2018",
  "deployment_model": [
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  "os_platforms": [
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  "features": [
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    "Generative and self-learning AI",
    "Automation at scale",
    "Intelligent reporting",
    "Real-time access",
    "Rapid onboarding",
    "Pre-claim provider education",
    "Elimination of abrasive payment integrity activities",
    "Comprehensive coverage across pre-claim, prepay, and postpay solutions",
    "Superior ROI with $60+ PMPY in cost savings",
    "Provider education and network services",
    "Payment integrity",
    "Special Investigation Units (SIU)",
    "Network management",
    "Clinical claim reviews",
    "Medical record reviews",
    "Data mining services",
    "Virtual SIU services"
  ],
  "optional_modules": [
    "Provider Scope",
    "Audit Scope",
    "Fraud Scope",
    "Payment Scope",
    "Clinical ClaimPilot",
    "Compliance ClaimPilot",
    "Concept ClaimPilot",
    "Medical Record Reviews Services",
    "Data Mining Services",
    "Virtual SIU Services"
  ],
  "integrations": [
    "HealthEdge Source"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
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  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
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    "HITECH",
    "SOC 2",
    "ISO 27001",
    "NIST 800-53 Revision 5"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO",
    "HITRUST"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "MVP Health Care",
    "Blue Cross Blue Shield health plans",
    "State Medicaid Agency Program Integrity Unit"
  ],
  "user_reviews": [
    "The platform identifies new issues rapidly, reducing the time lag between scheme emergence and detection.",
    "Codoxo's AI-driven solutions have significantly improved our payment accuracy and operational efficiency."
  ],
  "ratings": [
    "Fierce Healthcare Innovation Award winner",
    "Recognized by the Inc. 5000 list for growth",
    "2024 Leader in Technology Award in 'Excellence in AI Application' category"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2022",
  "integration_partners": [
    "HealthEdge"
  ],
  "id": "SW1122",
  "slug": "unified-cost-containment-platform",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/unified-cost-containment-platform.json"
  }
}