HealthEdge® and Codoxo have entered a strategic partnership aimed at offering healthcare payers advanced solutions for streamlined, end-to-end payment integrity. The collaboration combines HealthEdge Source™ with Codoxo’s GenAI-powered Unified Cost Containment Platform, creating a comprehensive system that enhances data integrity, speeds up value delivery, and allows health plans to consolidate vendor solutions.

HealthEdge Source is a leading pre-payment integrity solution that supports payment accuracy by integrating contract modelling, claim pricing, editing, and business intelligence. It addresses chronic payment errors through a proactive approach, reducing post-payment recovery needs. Codoxo’s Unified Cost Containment Platform, driven by AI and GenAI, includes tools for provider education, data analysis, medical policy compliance, fraud and abuse detection, and case management, collectively increasing cost savings and operational efficiency for health plans.

By centralising multiple services into a single integrated platform, HealthEdge and Codoxo help health plans reduce administrative expenses associated with managing multiple vendors and enhance transparency in addressing payment inaccuracies. Their joint platform supports payment integrity, clinical accuracy, network management, and special investigation unit operations, facilitating greater transparency, savings, and error detection, all while lowering operational costs.

HealthEdge and Codoxo’s alignment in deploying advanced AI technology enables earlier interventions within the claims lifecycle, ensuring that claims are accurately coded and paid correctly from the outset. This collaboration establishes a new industry standard for claim payment precision and operational efficiency, helping health plans improve cost containment and accuracy in payment processing.

Through this partnership, HealthEdge and Codoxo aim to provide expanded value to health plans, fostering a more affordable, efficient healthcare system and promoting a unified ecosystem that connects payers, providers, and patients.




Source: healthedge.com

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