CodaHx

CodaHx provides an AI-powered medical claims auditing platform designed for self-funded employers. The platform integrates directly with third-party administrators (TPAs) to analyze 835/837 medical claims in parallel with TPA processing, flagging billing errors before payments are issued. The AI engine detects upcoding, duplicate charges, unbundling, and pricing discrepancies by comparing flagged claims against hospital-published machine-readable file (MRF) data. CodaHx also monitors stop-loss thresholds in real time and identifies employees who may qualify for charity care or financial assistance programs. The platform generates ERISA-compliant audit trails and documentation. CodaHx estimates its system can save self-funded employers approximately 3% off every plan, with examples showing over $11,000 in savings on a single claim and roughly $550K annually for a company with $18M in annual claims spend. The company is HIPAA compliant with 256-bit encryption and bank-level security. CodaHx was part of the Techstars AI Health Baltimore fall 2025 accelerator cohort, supported by program anchors Johns Hopkins University and CareFirst Blue Cross Blue Shield.