Mar 3, 2026 | Payment Integrity
As healthcare organizations closed the books on 2025, one reality became unmistakable: payment integrity has reached an inflection point. Rising healthcare costs, persistent improper payments, growing provider burden, and accelerating regulatory complexity are...
Feb 25, 2026 | Payment Integrity
By Musheer Ahmed, PhD, Founder & CEO, Codoxo Over the past year, I’ve engaged in numerous discussions with health plan pharmacy benefit managers (PBM), and one recurring theme has been unmistakable: the current payment integrity model is no longer sustainable. The...
Dec 10, 2025 | Payment Integrity
The gap between fraud schemes and detection capabilities has never been wider. While fraudsters leverage AI to generate sophisticated fake documentation and scale schemes at unprecedented speed, most SIU and payment integrity teams remain trapped in manual workflows...
Nov 13, 2025 | Payment Integrity
Healthcare fraud investigation requires more than technical skills—it demands a solid understanding of legal foundations, theoretical frameworks, and strategic thinking. At a recent Codoxo industry event, Kelly Bennett, a payment integrity subject matter expert with K...
Sep 16, 2025 | Payment Integrity
In healthcare payment integrity, earlier intervention drives better outcomes. For too long, healthcare payers have been forced to chase errors after claims are created—through costly pre-payment reviews or even post-payment recovery. By that point, provider...
Aug 19, 2025 | Payment Integrity, Uncategorized
In the first two installments of our Point Zero Payment Integrity series, we explored how AI-powered concept ideation and proactive provider reimbursement policy education are moving payment integrity to the earliest intervention point. Now, we turn to the third and...
