$35M Investment Accelerates Gen AI Deployment at Point Zero — Empowering Payers to Act Earlier and Smarter Than Ever Before While Reducing Friction With Providers

DULUTH, Ga.–(BUSINESS WIRE)–Codoxo, the leading provider of AI and generative AI-powered healthcare payment integrity solutions, raised $35M in Series C funding, led by CVS Health Ventures. Echo Health Ventures joins the round as a new investor, with continued investment from existing investors including Sands Capital, 111 West Capital, Brewer Lane Ventures, Wipro Ventures, 450 Ventures (venture arm of Blue Cross and Blue Shield of Alabama) and QED Investors. This milestone brings Codoxo’s total funding raised to over $75 million.

Codoxo’s platform is rapidly being adopted by national health plans, and the latest investment will accelerate the company’s growth and its speed of innovation in its GenAI-powered payment integrity solutions. By targeting payment accuracy at Point Zero, Codoxo is transforming how payers and providers collaborate—delivering improvements that were previously unachievable with traditional methods.

The funding comes at a pivotal time as healthcare payers face mounting pressure to reduce costs while improving provider relationships. Codoxo’s Point Zero approach represents a fundamental shift in payment integrity, identifying and preventing payment errors at the earliest possible moment —before they occur —rather than detecting them after the fact.

“This funding highlights the support for Codoxo’s differentiated approach and the importance of closing gaps in payment integrity programs across national health plans,” said Musheer Ahmed, Ph.D., CEO and Founder of Codoxo. “Payers are increasingly seeking innovative solutions that deliver greater payment accuracy while improving provider experience and reducing the administrative burden created by traditional payment integrity processes.”

“With this investment, we’re accelerating the scaled deployment of our Point Zero Payment Integrity solutions, powered by generative AI,” said Ahmed. “We’re proud to be the first intelligent, end-to-end payment integrity platform that thoughtfully determines which providers require intervention—whether at Point Zero, prepay, or postpay—ensuring smarter, more efficient outcomes across the entire claims process.”

This funding follows a transformative year for Codoxo, marked by rapid expansion of its customer base—now covering more than 80 million lives—and significant revenue growth. The company was once again recognized on the Inc. 5000 list of the Fastest-Growing Private Companies in the U.S., reflecting its sustained momentum and market impact. Codoxo continues to deliver unprecedented results for national payers by closing costly payment gaps through its Point Zero Payment Integrity platform, which was named a 2025 AI Awards finalist in two categories: Most Innovative AI Technology and Best Use of AI in Healthcare.

“Codoxo’s Point Zero approach and proven track record at national health plans position them uniquely to improve how payers ensure payment accuracy at scale,” said Justin Brock, Partner at CVS Health Ventures. “We’re excited to support their mission to enhance payment integrity programs across the entire industry.”

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. 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. The platform’s comprehensive AI capabilities span across 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. These help payers achieve unmatched accuracy across the entire claim lifecycle. Codoxo’s platform transforms payment integrity by shifting payers from reactive detection to proactive prevention—reducing costs and improving provider relationships. Codoxo has been recognized with a Fierce Healthcare Innovation Award and named to the Inc. 5000 list for its rapid growth. All Codoxo solutions operate in a HITRUST-certified environment. For more information, visit www.codoxo.com.

Contacts

Media contact:
Michelle Mead
VSC for Codoxo
codoxo@vsc.co

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