# Codoxo

> Codoxo is an Atlanta-area enterprise software company that applies patented AI and generative AI to healthcare payment integrity. Its platform helps health plans, pharmacy benefit managers and government agencies find fraud, waste, billing errors and policy gaps across the claim lifecycle, while its newer Point Zero strategy tries to prevent avoidable errors through policy development and provider education before a claim is submitted.

- **Founded:** 2017
- **Headquarters:** Duluth, Georgia, United States
- **Founders:** Musheer Ahmed (CEO and Co-Founder), Mustaque Ahamad (Chief Scientist and Co-Founder)
- **Team size:** Approximately 96 employees shown on LinkedIn as of 2026; the company lists a 51-200 employee range.
- **Products:** Forensic AI Engine, Fraud Scope, Provider Scope, Payment Scope, Audit Scope
- **Notable:** Won the 2016 Atlanta Startup Battle as FraudScope., Named one of Georgia's Top 10 Most Innovative Companies by the Technology Association of Georgia in 2021., Won a Fierce Healthcare Innovation Award in the Data Analytics/Business Intelligence category.

## Products & services

- **Forensic AI Engine** — The patented behavioral-analytics foundation that analyzes claims and relationships to identify anomalies and emerging patterns beyond static rules.
- **Fraud Scope** — Fraud, waste and abuse detection with provider risk scoring, outlier analytics, evidence management, case workflow and generative-AI-assisted record review.
- **Provider Scope** — Identifies provider coding outliers and supports targeted education before policy changes and as billing patterns evolve.
- **Payment Scope** — Prepay and postpay claim review workflow that flags payment issues and supports analyst follow-up and outreach.
- **Audit Scope** — Audit, case-management and workflow automation for payment-integrity and investigation teams.
- **ClaimPilot** — A generative-AI suite for concept ideation, policy testing, clinical chart review and compliance analysis, including Concept, Clinical and Compliance ClaimPilot tools.
- **Point Zero Payment Integrity** — A pre-claim model combining no-code policy development, policy education and ongoing coding-accuracy education to prevent avoidable errors before submission.
- **AI Data Health Integrity Agent** — Scans and validates payer claim datasets before submission to reduce implementation delays caused by data-quality problems.
- **Deepfake Detection** — Detects synthetic, manipulated, cloned or partially AI-generated medical documentation and diagnostic images before payment.
- **Expert Services** — Medical and complex chart review, data mining and virtual special-investigation-unit services that complement the software platform.

## Achievements

- Won the 2016 Atlanta Startup Battle as FraudScope.
- Named one of Georgia's Top 10 Most Innovative Companies by the Technology Association of Georgia in 2021.
- Won a Fierce Healthcare Innovation Award in the Data Analytics/Business Intelligence category.
- Named to the Inc. 5000 for three consecutive years through 2025.
- Reported more than 80 million covered lives by December 2025.
- Point Zero Payment Integrity was a 2025 AI Awards finalist for Most Innovative AI Technology and Best Use of AI in Healthcare.
- Maintains a HITRUST-certified operating environment and reported NIST 800-53 Revision 5 compliance for a second consecutive year in 2025.
- Raised more than $75 million in total funding by the close of its 2025 Series C.

## Latest updates

- **2026-03** — Launched Deepfake Detection for synthetic or manipulated medical records and diagnostic images, with deployments underway at U.S. health plans.
- **2025-12** — Closed an oversubscribed $35 million Series C led by CVS Health Ventures; the company said its customer base covered more than 80 million lives.
- **2025-08** — Appeared on the Inc. 5000 for the third consecutive year.
- **2025-05** — Formally launched Point Zero Payment Integrity, a pre-claim provider-education and policy-development model.
- **2025-03** — Introduced an AI Data Health Integrity Agent to catch dataset-quality issues before payer files enter implementation.
- **2024-11** — Announced a strategic integration partnership with HealthEdge.

## Links

- Website: https://www.codoxo.com/
- LinkedIn: https://www.linkedin.com/company/codoxo
- Twitter/X: https://twitter.com/CodoxoInc
- YouTube: https://www.youtube.com/channel/UCkMdMBNNDNzdm6H4m1l9gmw

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Profile page: https://yespress.io/codoxo
Published by YesPress — https://yespress.io
Last updated: 2026-08-22