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Founded in 2006 by industry veterans with first-hand experience, CODY® is an Industry leader in Governance, Risk, and Compliance (GRC) Solutions designed exclusively for health plans. We enable over 70 government-funded, commercial, and ACA health plans across 50 states and Puerto Rico to mitigate compliance risk, increase accuracy, maximize efficiencies, reduce administrative costs, and improve outcomes for plan members and providers.

CODY’s Compliance Consulting and Operational Support Teams help mitigate risk and ensure compliance and supports all government healthcare operations:

CODY® Consulting Operational Staffing Support:
• Special Needs Plans/Model of Care
• Project Management
• Audits/Surveys and audit support (CPE, FDR Oversight, Pre-delegation, CMS Program Mock Audits and audit support, One Third Financial Audit support, Validation, Call Center, QHP Provider Wait Time Secret Shopper, Provider Directory Accuracy/Access)
• New plan/product implementation
• Policy/Operations assessment and development
• Business Process Outsourcing and Supplemental Staffing
• Member/Plan Communications (ANOC, EOC, SB, SBC, Handbook, formulary, provider directories)

Our CodySoft® Enterprise Platform features comprehensive suites of proprietary software and services to support Member/Provider Communications, Compliance, and Operations:

CodySoft® Member/Provider Communications:
• Plan Benefit Package Module®
• Collateral Management Module®
• Translations Services
• 508 Remediation Services
• Provider & Pharmacy Directory Module®
• CodyPrint® Print & Fulfillment
• ePresentment Module™
• Member Fulfillment, Reporting & Analytics
• Online Ordering & Fulfillment
• Direct Marketing: Data Analytics, Member Acquisition & Retention

CodySoft® Compliance:
• Compliance Correspondence Module® (regulatory communication, manage oversight activities)
• HPMS Memo Module®
• Policy and Procedures Module®
• Risk Management Module®
• Incident Management Module®

CodySoft® Operations:
• Appeals and Grievances Module®
• Membership Suite:
     – Enrollment Solution
     – Billing Solution
     – Reconciliation Solution
               ¤ Other Health Information (OHI: Medicare Secondary Payer (MSP)™, Coordination of Benefits (COB)™
               ¤ Retro Processing Contractor (RPC: RPC, Submission and Tracking, Enrollment Data Validation (EDV) Submission, Attestation Reporting
               ¤ Daily Operational Management: Daily Transaction Reply Report (DTRR)™, Out of Area (OOA)/State & County Code (SCC) Change Management & Tracking
               ¤ Member Correspondence/Letter Management
               ¤ Monthly Reconciliation Process: Monthly Membership Report (MMR)™, Monthly Premium Withold Report (MPWR)™. Late Enrollment Penalty (LEP)™, Low Income Subsidy (LIS)™

Contact:
Debbie R. Mabari
CEO
818.439.3922
dmabari@codyconsulting.com

PO Box 47119
Tampa, FL 33646
www.codyconsulting.com