Medicare Advantage & Prescription Drug Plans (MAPD) is our core business.

Our highly-skilled workforce of subject matter experts (SMEs) is nationwide. Nearly every member of our team has worked with or for a health plan. Our depth and breadth of industry knowledge continue to drive our mission to develop the most practical “innovative firsts” and “best-in-class solutions” to support the ongoing challenges facing health plans. Our products and services are comprehensive, cost-effective, and results-driven to help clients maximize operational performance and achieve a favorable return on investment (ROI).

So, they can better serve their valued health plan members, reduce administrative costs, generate new revenue, and thrive in a highly competitive, regulated marketplace.

What sets us apart?

  • We are Industry veterans with first-hand experience.
    As former health plan employees and seasoned subject matter experts, our industry knowledge is highly skilled and distinctly specialized. We understand the challenges health plans face and provide the most practical solutions to support the healthcare regulatory environment and industry best practices.
  • Our Enterprise Solutions are developed exclusively for health plans.
    We do not retrofit generic products created to serve multiple industries. Our products and services are developed specifically for health plans. Our consulting services are highly customized to address operational gaps, align with your business, and fit your specific needs.
  • Our Proprietary Software is industry-ready “out-of-the-box.”
    Efficiency matters. CodySoft® is intuitive, easy to implement, and quick to learn. There is no need for onsite implementation, no special coding skills are required, and there’s no hardware or software to install. Offered individually or integrated as a bundle, our suites of modules are highly adaptable, scalable, and designed to grow with you.
  • Our Commitment to hands-on guidance, training, and support are unsurpassed.
    We value responsiveness, collaboration, and deliver on promise. We take great pride in being available when you need us. We’re flexible, quick to adapt, and prepared to mitigate issues before they arise.
  • Our Approach is comprehensive, cost-effective, and results-driven.
    We have led the industry for decades. Our products and services are innovative, practical, and proven to maximize operational performance, improve outcomes, and provide a favorable return on investment (ROI).
  • But most of all—We believe in the Power of Passion.
    It’s a fundamental difference and drives our sense of purpose. Our dedication to develop and deliver the most innovative technology and best-in-class solutions empowers our mission.

Success Story:

By implementing the CodySoft Recon™ MPWR module, 7,000 members were identified as “not billed” for their premium in over 3 years. Internal reconciliation processes failed to identify discrepant premium payment options. Plan data showed SSA withholding was on however, CMS systems showed direct bill—resulting in $1.2M of lost revenue.

Large East-Coast BCBS Associated Health Plan