Case Study: BlueCross BlueShield Health Plan reduces medical and dental fraud, waste, and abuse with Codoxo

BlueCross BlueShield Health Plan reduces medical and dental fraud, waste, and abuse with Codoxo

BlueCross BlueShield Health Plan, a leading midwestern healthcare payer, faced significant financial losses due to its inability to effectively detect and protect against fraudulent and wasteful billing practices, such as non-traumatic dental services billed under medical insurance. The company lacked the necessary technology, data, and clinical staff to catch this behavior early. To address this challenge, they partnered with vendor Codoxo for its fraud, waste, and abuse solution.

By implementing Codoxo's technology, the health plan was able to reduce its medical and dental fraud, waste, and abuse. This solution provided the payer with the advanced capabilities needed to identify outlier billing behavior effectively. As a result, Codoxo helped BlueCross BlueShield protect its budget and improve its bottom line by curtailing these significant losses.

BlueCross BlueShield Health Plan