Codoxo Introduces AI Tool to Automate Healthcare Claim Audits

Health-focused artificial intelligence (AI) company Codoxo has debuted a new tool to automate claim audits.

In releasing its ClaimPilot product, the company can address the “most dire need” facing healthcare companies, according to a Monday (July 31) press release.

“In-patient and facility claims account for a significant portion of costs in healthcare,” Codoxo said in the release. “Yet due to their complex nature, healthcare payers, third-party administrators and government agencies typically focus most of their constrained resources on auditing professional claims.”

With ClaimPilot, Codoxo said in the release it aims to fuel an “exponential increase in audit turnaround times and clinician audits per day,” while doing away with “dollar thresholds that restrict claims analysis to higher dollar ranges.”

Beyond dealing with audits, Codoxo said in the release it also plans to integrate ClaimPilot with all its AI products, “addressing the entire payment integrity lifecycle.”

“Today, it takes a clinician an average of 15 days to review a single in-patient or professional claim audit, from the time records are received to the time the audit is complete,” said Codoxo Vice President of Analytics Jesse Montgomery in the release. “With ClaimPilot, the turnaround time will be less than 24 hours.”

The launch is happening as many observers believe that healthcare is the field with the greatest potential for AI to transform.

AI can introduce “a connected, ambient patient environment” that streamlines the increasingly complex and sprawling administrative workflows of the healthcare field, PYMNTS wrote Friday (July 28).

Recent weeks have seen several companies roll out AI-centric health products, like Amazon Amazon Web Services’ (AWS) HealthScribe, an AI for healthcare solution that leverages speech recognition and generative AI to create clinical documentation, allowing clinicians to save time summarizing patient visits.

Meanwhile, Google Cloud and Mayo Clinic are working together to use generative AI in healthcare by offering solutions that help clinicians and researchers unearth information in a way that is fast, seamless and conversational.

And Microsoft last year spent $16 billion to buy AI speech technology firm Nuance Communications, a company whose transcription technology for doctors serves more than three-quarters of the hospitals in the U.S.