The future of payment integrity lies in the ability to harness Artificial Intelligence (AI) and Generative AI (GenAI) to improve outcomes. Yet, achieving measurable success requires more than just adopting technology—it demands the ability to set, track, and optimize benchmarks that align with your organization’s goals.
This session will dive into how healthcare payer executives can establish meaningful benchmarks to evaluate the impact of AI and GenAI on payment integrity. Learn how to define key performance indicators (KPIs) for fraud detection, cost savings, compliance improvements, and operational efficiencies. Explore strategies for tracking progress, identifying opportunities for refinement, and ensuring that your AI initiatives consistently deliver high-value results.
With a focus on real-world use cases and data-driven insights, attendees will walk away with actionable steps to enhance payment integrity outcomes through benchmark-driven approaches. Join us to discover how setting the right standards can help your organization maximize the potential of AI and GenAI, driving stronger financial and compliance performance.
Musheer Ahmed, PhD
Dr. Ahmed is the CEO and Founder of Codoxo. He founded Codoxo (formerly named FraudScope) to help make our healthcare system more affordable and effective. Codoxo’s Unified Cost Containment Platform uses AI to identify inaccurate payments earlier than traditional techniques, which helps ensure our scarce healthcare dollars go to real patient care. Dr. Ahmed developed this technology as a part of his Ph.D. dissertation at the Georgia Institute of Technology. A report by the JASON advisory group, the prestigious scientific advisory panel to the US government, reinforced that his doctoral research tackled some of the biggest challenges within the emerging health data infrastructure in the United States. Dr. Ahmed was honored to be included in the 40 Under 40 lists by Georgia Tech and the Atlanta Business Chronicle. Several media outlets have interviewed Dr. Ahmed about his work in reducing healthcare fraud, waste, abuse, and error. When he’s not eliminating payment inaccuracies, you’ll find him volunteering for various causes and spending time with his family.
Ric Baron, PhD
Dr. Ric Baron is a healthcare technology strategist, AI analytics leader, and product
architect with over 20 years of experience in healthtech and insurtech. As Vice President of AI at Codoxo, he drives AI innovation and strategy, leading the development of advanced solutions for detecting fraud, waste, and abuse in healthcare—working toward the mission of making healthcare more affordable and accessible.
Before joining Codoxo, Dr. Baron led computational healthcare research initiatives at world-renowned institutions, including the Howard Hughes Medical Institute, UC San Diego, and the Huntsman Cancer Institute at the University of Utah. He also served as a supercomputing advisor to The National Academies of Sciences, Engineering, and Medicine.
Dr. Baron has held senior leadership roles at companies such as Komodo Health, CVS Health, and Swiss Re, contributing his expertise in AI and data-driven healthcare solutions.
He earned his PhD in Computer-Aided Chemistry from ETH Zürich.
Codoxo
Website: www.codoxo.com
With a mission to make healthcare more affordable and effective for everyone, Codoxo is the leader in AI-powered payment integrity solutions for healthcare payers. The company's GenAI-driven Unified Cost Containment Platform delivers intelligent, end-to-end payment accuracy and fraud, waste, and abuse (FWA) detection from pre-claim through prepay to postpay. At the earliest intervention point, Codoxo's Point Zero Payment Integrity solutions identify and prevent payment errors before claims are even submitted—stopping issues at their source. Combined with the platform's comprehensive prepay and postpay capabilities—including advanced data mining, fraud detection, medical policy and contract compliance, medical record reviews, provider education, and intelligent audit and case management—Codoxo enables healthcare payers to achieve unprecedented accuracy across the entire claim lifecycle. Powered by generative AI and Codoxo's patented Forensic AI technology, the platform transforms payment integrity by shifting payers from reactive detection to proactive prevention, reducing costs and improving accuracy at scale. Codoxo is a Fierce Healthcare Innovation Award winner and has been recognized on the Inc. 5000 list for growth. Our solutions are HIPAA-compliant and operate in a HITRUST-certified environment. For more information, visit https://link.edgepilot.com/s/57167cca/YjEmYv2dokSB2REStzH5Cw?u=http://www.codoxo.com/.
