Jim Brady of Codoxo and Wendy Luc-Pepin of UnitedHealth Group will explore how complementary data sources can reveal overlooked anomalies, strengthen investigative leads, and help teams determine where to focus further investigation.
DULUTH, Ga.–(BUSINESS WIRE)–Codoxo, the leading provider of AI and generative AI-powered healthcare payment integrity solutions, today announced it will share how payers can look beyond claims data to uncover overlooked fraud patterns and build stronger investigative leads during a live session at the National Health Care Anti-Fraud Association (NHCAA) Annual Training Conference, taking place Nov. 3-6 at the Town & Country San Diego Resort.
The session, “Using Complementary Data Sources to Identify Anomalies That Merit Further Investigation,” will take place Thursday, Nov. 5, from 1:30 to 2:30 p.m. PT in Palm Room 1-3. Jim Brady, vice president of growth at Codoxo, and Wendy Luc-Pepin, senior director of fraud, waste and abuse operations at UnitedHealth Group, will discuss how payers, special investigations units and investigative teams can look beyond traditional claims to find patterns, outliers and inconsistencies that justify deeper review.
Healthcare organizations are processing more claims and facing more complex fraud, and claims data alone often can’t tell the full story. Drawing on real-world case studies, the session will show how combining claims with complementary data sources helps organizations to sharpen prioritization, build stronger cases and rule out false positives before investigative resources are committed. Those sources include provider licensure and exclusion records, network relationship data, electronic health record metadata and geospatial billing patterns. Attendees will leave with a practical framework for cross-referencing data sources and a clearer view of when suspicious indicators are enough to build a case.
“Fraud schemes are evolving faster than any single data source can keep up with, especially as AI makes fabricated healthcare documentation easier to produce,” said Jim Brady, vice president of growth at Codoxo. “Investigators need a fuller picture before they act.”
Codoxo is an NHCAA Platinum Supporting Member, and attendees can visit the team at Booth 203 throughout the conference to learn more about Codoxo’s Unified Cost Containment Platform and its capabilities across the healthcare payment lifecycle. Attendees can also stop by the Codoxo Headshot Lounge at the booth for a professional headshot.
About Codoxo
Codoxo empowers healthcare payers with its Generative AI-driven Unified Cost Containment Platform, delivering intelligent, end-to-end payment integrity and fraud, waste, and abuse (FWA) solutions — from pre-claim to prepay and postpay. The platform’s AI capabilities span provider education, data mining, clinical chart and medical record reviews, no-code concept ideation, fraud detection, audit workflow and case management, and provider contract and medical policy compliance. Codoxo has been recognized with a Fierce Healthcare Innovation Award, named to the Inc. 5000 list for its rapid growth, and included in TIME’s World’s Top HealthTech Companies 2026 list. All Codoxo solutions operate in a HITRUST-certified environment. For more information, visit www.codoxo.com.
About NHCAA
Founded in 1985 by several private health insurers and federal and state government officials, the National Health Care Anti-Fraud Association is the leading national organization focused exclusively on the fight against health care fraud. We are a private-public partnership – our members comprise nearly 90 private health insurers and those public-sector law enforcement and regulatory agencies having jurisdiction over health care fraud committed against both private payers and public programs. Established in 2000, The NHCAA Institute for Health Care Fraud Prevention is a separately incorporated, tax-exempt educational foundation that provides education and training to private- and public-sector health care anti-fraud personnel.
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