Payment fraud in healthcare is getting harder to detect. Here’s how to fight back.

What used to be simple forgery or stolen checks has evolved into coordinated attacks that exploit every weak spot in the claim payment process. From account takeovers and phishing attacks to redirected payments, healthcare payment fraud is becoming more sophisticated — and harder to detect.

The scale is staggering as billions of dollars move through healthcare claim payments every day, giving fraudsters more opportunities and payers more exposure. In June 2025, the Department of Justice charged 324 defendants in connection with healthcare fraud schemes totaling more than $14.6 billion dollars in intended losses .

Payment fraud is no longer an isolated issue; it is a systemic challenge that drains resources, erodes provider trust, jeopardizes reputation, and increases