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Codoxo Empowers Healthcare Organizations to Identify and Avoid Fraud With Monthly Forensic AI Alerts

AI Alerts help healthcare leaders prepare for a better tomorrow through critical updates for cost containment and payment integrity teams.

Codoxo, a trusted provider of healthcare artificial intelligence solutions,announced its Forensic AI Alert Series, a monthly report that empowers healthcare cost containment and payment integrity teams to identify and manage rapidly emerging fraud schemes that increase financial risk. Research shows that three-quarters of healthcare executives say that cost containment is a high priority for them in 2022 and more than a third (37%) say it’s their top focus.

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Codoxo’s Forensic AI Alerts are developed by a team of payment integrity and fraud, waste, and abuse (FWA) experts. They cover critical fraud updates, data mandates, and coding changes that are difficult for internal SIU and payment integrity teams to track while providing best practices and specific steps on how to act upon them. Topics covered include:

  • New and emerging schemes to watch
  • Code updates – procedure, diagnosis, evaluation, especially those that could be ripe for fraud
  • Coverage criteria updates
  • Supplemental references
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“Our Forensic AI Alerts allow us to consistently share the timeliest facts and most urgent recommendations on healthcare fraud and abuse topics that have the real potential to negatively impact healthcare plans and others in the healthcare ecosystem,” said Rena Bielinski, PharmD, AHFI, Codoxo VP of Customer Success. “Healthcare leaders are craving more knowledge about ways to better manage costs and avoid fraud and waste, but often find it challenging to track and monitor that information themselves. We’re dedicated to helping our customers do just that every day.”

The alerts have already proved valuable in addressing ongoing concerns across many emerging areas of COVID-19, including:

  • Vaccination status diagnosis codes
  • Latest testing guidelines
  • Vaccine and administration codes
  • Post COVID-19
  • Telehealth

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