What You Should Know:
– HealthEdge® and Codoxo announce a strategic partnership to provide healthcare payers with the industry’s most cutting-edge solutions and services.
– This partnership will streamline and enhance their respective end-to-end payment integrity processes by leveraging HealthEdge Source™ in conjunction with Codoxo’s GenAI-driven Unified Cost Containment Platform. By joining forces to deliver an end-to-end payment integrity solution, healthcare payers will benefit from the ability to consolidate vendor solutions, improve data integrity, and accelerate time-to-value.
Driving Efficiency and Innovation in Healthcare: The HealthEdge-Codoxo Partnership
HealthEdge® and Codoxo are transforming healthcare through a collaborative effort to deliver market-leading payment integrity solutions. Their partnership aims to enhance transparency, accuracy, and efficiency in health plan operations while reducing overhead costs and vendor dependency. This initiative supports the broader goal of making healthcare more affordable, effective, and connected for payers, providers, and patients.
Integrated Payment Integrity Solutions
HealthEdge Source™, a leading payment integrity solution, offers:
– Advanced contract modeling and configuration capabilities
– Enhanced claim pricing, editing, and proactive business intelligence
– Seamless identification and resolution of chronic payment errors
Complementing this, Codoxo’s Unified Cost Containment Platform integrates:
– AI and generative AI-powered provider education
– Data mining, medical record reviews, and fraud detection tools
– Compliance with medical policies and provider contracts
– Comprehensive audit and case management features
Together, these technologies provide health plans with increased savings and operational efficiency by addressing payment inaccuracies early in the claim lifecycle.
Advantages of the HealthEdge-Codoxo Collaboration
HealthEdge and Codoxo combine their strengths to address key challenges faced by health plans, including:
– Eliminating the need for multiple vendors, thereby lowering administrative costs
– Improving transparency across payment integrity, clinical, and investigative processes
– Delivering more precise and efficient payment accuracy solutions
Leadership in Healthcare Innovation
HealthEdge’s comprehensive ecosystem, featuring solutions like HealthRules® Payer for core administration, GuidingCare® for care management, and Wellframe™ for member experience, integrates seamlessly with Codoxo’s advanced AI-driven tools. This collaboration strengthens their shared commitment to innovation, excellence, and affordability in healthcare.
Recognized by leading organizations such as Gartner, KLAS, and BlackBook, and celebrated as one of the Best and Brightest Companies to Work For in the Nation, HealthEdge continues to lead the digital transformation of healthcare. This partnership reinforces its dedication to fostering a cohesive ecosystem that connects all stakeholders in healthcare—payers, providers, and members.
“A forward-looking approach to pre-pay payment integrity reduces the need for costly post-payment recoveries, minimizes provider abrasion, and improves the quality of our healthcare system,” said Ryan Mooney, Executive VP & General Manager of HealthEdge Source. “Our strategic partnership with Codoxo aligns one HealthEdge managed data source, feeding two cutting-edge technology platforms, to empower health plans with the information they have always wanted to correct any process errors, further upstream than previously possible, before the claim is paid.”
