Apr 29, 2026 | Payment Integrity
A New Approach to an Old Problem Federal health programs face a persistent and growing challenge: how to safeguard critical healthcare dollars while continuing to deliver timely, high-quality care to millions of Americans. Improper payments, fraud schemes, and...
Apr 8, 2026 | Payment Integrity
Throughout 2025, payment integrity teams faced a steady stream of new billing behaviors, emerging fraud patterns, and regulatory nuance. While many industry conversations focused on high-level trends, a different story unfolded closer to operations — one revealed...
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...
