Codoxo to Showcase Innovative Payment Integrity Solutions at NAMPI 2025 Conference
Codoxo, a forefront player in AI-driven payment integrity solutions in the healthcare sector, is excited to announce its participation as a Platinum Sponsor at the 2025 National Association for Medicaid Program Integrity (NAMPI) Annual Conference. The conference is scheduled to take place from August 24 to 26 at the Marriott St. Louis Grand in St. Louis, Missouri. During this important event, Codoxo will take the stage alongside CalOptima Health for a session titled "AI-Powered Program Integrity: How CalOptima's SIU Transformed Fraud Detection Through Strategic AI Implementation." This session is scheduled for Monday, August 25, from 11:30 AM to 12:30 PM and will feature insights from Matt Smith, Healthcare Fraud Analyst at Codoxo, and Cynthia Valencia, Manager of Regulatory Affairs and Compliance at CalOptima Health.
The discussion will cover how AI technologies can revolutionize fraud detection in healthcare. Codoxo aims to highlight real-life instances where AI has successfully identified fraudulent activities and demonstrate the efficiency of its healthcare fraud detection solutions, which are recognized as the fastest and most accurate in the industry.
Navigating Challenges with Point Zero Payment Integrity
As the U.S. government deliberates on potentially severe budget cuts to Medicaid funding by 10 to 15 percent, states face tough choices regarding beneficiary coverage and provider reimbursements. Codoxo proposes an innovative alternative through its Point Zero Payment Integrity framework. This groundbreaking approach emphasizes proactive intervention before claims are filed, effectively preventing waste often overlooked by traditional methodologies.
"With increasing financial pressure on public health systems, relying solely on retrospective reviews cannot suffice anymore," stated Dr. Musheer Ahmed, Founder and CEO of Codoxo. "Our Point Zero strategy not only detects issues early on but also fosters provider education prior to claims submission, thereby yielding better health outcomes, minimizing waste, and enhancing collaboration among stakeholders."
Codoxo's tactics are especially vital in light of the significant $800 billion Medicaid funding cuts looming ahead. The recent legislative measures, including a ten-year, 12 percent reduction in support for Medicaid, underscore the urgent demand for innovative solutions that safeguard limited resources. Codoxo empowers government entities, insurers, and pharmacy benefit managers (PBMs) to transition from reactive post-payment procedures to strategic, data-driven actions at the earliest claim lifecycle stages.
Proven Results Through Innovative Practices
Codoxo's Point Zero Payment Integrity solutions have successfully demonstrated:
By unifying data across various claim types, including professional and pharmacy claims, Codoxo's AI platform fosters real-time collaboration among Special Investigations Unit (SIU), clinical, and provider teams. This integration enables payers to manage expenses more effectively and bolster compliance from the ground up.
Codoxo will be hosting interactive demonstrations of the Point Zero framework at Booth #16 during the conference. As states confront unprecedented financial hurdles, the Point Zero approach presents a viable pathway forward, ensuring the protection of beneficiaries while maximizing the impact of available resources through intelligent early intervention. Attendees are encouraged to visit Codoxo's booth to learn more or to arrange a meeting via their website. For insights into Codoxo's Point Zero solutions, including education on fraud, waste, and abuse, data mining, and much more, visit Codoxo's NAMPI 2025 information page or check their main website at www.codoxo.com.
About Codoxo
Codoxo's mission is to transform healthcare into a more affordable and efficient system for all. They are recognized as a leading provider of generative AI and advanced artificial intelligence solutions that empower healthcare payers to detect and resolve payment integrity challenges proactively from the commencement of the claims process—spanning pre-claim to prepay and postpay phases. Their Unified Cost Containment Platform utilizes generative AI to assist payers in achieving savings through comprehensive approaches like provider training, data mining, medical review processes, and compliance audits. Developed on a robust Forensic AI Engine, Codoxo's solutions outpace traditional methods, identifying payment discrepancies more swiftly and accurately. Codoxo has earned a place on the Inc. 5000 list for notable growth and has received the Fierce Healthcare Innovation Award for its contributions to the industry. Their solutions adhere to HIPAA regulations and function within a HITRUST-certified environment. To understand more about Codoxo's work, visit their official website at www.codoxo.com.
The discussion will cover how AI technologies can revolutionize fraud detection in healthcare. Codoxo aims to highlight real-life instances where AI has successfully identified fraudulent activities and demonstrate the efficiency of its healthcare fraud detection solutions, which are recognized as the fastest and most accurate in the industry.
Navigating Challenges with Point Zero Payment Integrity
As the U.S. government deliberates on potentially severe budget cuts to Medicaid funding by 10 to 15 percent, states face tough choices regarding beneficiary coverage and provider reimbursements. Codoxo proposes an innovative alternative through its Point Zero Payment Integrity framework. This groundbreaking approach emphasizes proactive intervention before claims are filed, effectively preventing waste often overlooked by traditional methodologies.
"With increasing financial pressure on public health systems, relying solely on retrospective reviews cannot suffice anymore," stated Dr. Musheer Ahmed, Founder and CEO of Codoxo. "Our Point Zero strategy not only detects issues early on but also fosters provider education prior to claims submission, thereby yielding better health outcomes, minimizing waste, and enhancing collaboration among stakeholders."
Codoxo's tactics are especially vital in light of the significant $800 billion Medicaid funding cuts looming ahead. The recent legislative measures, including a ten-year, 12 percent reduction in support for Medicaid, underscore the urgent demand for innovative solutions that safeguard limited resources. Codoxo empowers government entities, insurers, and pharmacy benefit managers (PBMs) to transition from reactive post-payment procedures to strategic, data-driven actions at the earliest claim lifecycle stages.
Proven Results Through Innovative Practices
Codoxo's Point Zero Payment Integrity solutions have successfully demonstrated:
- - Up to a 40% reduction in overpayments,
- - Total savings of $12 to $16 PMPY through proactive provider educational efforts,
- - A 42% decrease in administrative costs,
- - Efficiency enhancements for integrity teams by 20 to 30 times.
By unifying data across various claim types, including professional and pharmacy claims, Codoxo's AI platform fosters real-time collaboration among Special Investigations Unit (SIU), clinical, and provider teams. This integration enables payers to manage expenses more effectively and bolster compliance from the ground up.
Codoxo will be hosting interactive demonstrations of the Point Zero framework at Booth #16 during the conference. As states confront unprecedented financial hurdles, the Point Zero approach presents a viable pathway forward, ensuring the protection of beneficiaries while maximizing the impact of available resources through intelligent early intervention. Attendees are encouraged to visit Codoxo's booth to learn more or to arrange a meeting via their website. For insights into Codoxo's Point Zero solutions, including education on fraud, waste, and abuse, data mining, and much more, visit Codoxo's NAMPI 2025 information page or check their main website at www.codoxo.com.
About Codoxo
Codoxo's mission is to transform healthcare into a more affordable and efficient system for all. They are recognized as a leading provider of generative AI and advanced artificial intelligence solutions that empower healthcare payers to detect and resolve payment integrity challenges proactively from the commencement of the claims process—spanning pre-claim to prepay and postpay phases. Their Unified Cost Containment Platform utilizes generative AI to assist payers in achieving savings through comprehensive approaches like provider training, data mining, medical review processes, and compliance audits. Developed on a robust Forensic AI Engine, Codoxo's solutions outpace traditional methods, identifying payment discrepancies more swiftly and accurately. Codoxo has earned a place on the Inc. 5000 list for notable growth and has received the Fierce Healthcare Innovation Award for its contributions to the industry. Their solutions adhere to HIPAA regulations and function within a HITRUST-certified environment. To understand more about Codoxo's work, visit their official website at www.codoxo.com.
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