The most dangerous moment in hospital finance operations isn’t when the payment is released — it’s everything that comes before it.
Every vendor and business-to-business (B2B) payment, patient refund, and accounts payable transaction represents a potential entry point for fraud. One compromised email, altered bank detail, or missed red flag can result in significant financial loss, operational disruption, and erosion of hard-earned trust.
Healthcare organizations operate within complex financial ecosystems, spanning supply chains, revenue cycles, and vendors. As payment volumes grow, so does their appeal to cybercriminals. Today’s fraud schemes move quickly and evolve constantly, often exploiting the operational gaps that exist within fragmented payment processes.
The Hidden Risk in B2B and Vendor Payments
For more than two decades, payments innovation in healthcare focused primarily on the patient payment experience and claims workflows, mirroring the rapid progress seen in consumer banking. Vendor payments, accounts payable processes, and other B2B transactions received far less attention. As a result, many of these systems remain fragmented, manual, and dependent on legacy verification processes.
The scale of B2B payments makes this potential exposure significant. The ACH Network reached new heights in 2025 with nearly 8.1 billion B2B payments, while healthcare claim payments from insurers to medical and dental providers approached 548 million transactions, up 7.3% year over year. This is creating a massive financial ecosystem that is increasingly attractive to fraudsters.
At the same time, early indicators suggest the threat is already accelerating. In 2024, 79% of organizations reported experiencing payment fraud attacks or attempts, with vendor impersonation and business email compromise among the most common tactics. As B2B payment systems continue to digitize and scale, attackers are increasingly targeting the operational gaps that legacy processes leave behind.
How Hospitals Can Strengthen Fraud Defense
Fraud tactics are sophisticated and can overwhelm even the most well-resourced teams. To combat this, healthcare organizations need to develop strategies that include the following steps.
Break Down Data Silos
Fraud indicators rarely appear in isolation. Connecting insights across accounts payable, vendor management, IT, and payment systems can reveal suspicious patterns — such as a sudden change in banking details paired with unusual login behavior — that siloed systems often miss.
Monitor Emerging Threat Signals
Fraudsters often post compromised credentials and payment data on the dark web before using them. Early visibility into these signals gives teams time to reset access, verify changes, and reduce exposure before funds move.
Strengthen Authentication Controls
Multi-factor authentication (MFA), one-time passcodes, and layered verification should be standard across all payment platforms. Effective authentication adds friction for attackers, even when credentials are compromised.
Apply Risk Scoring and Behavioral Analysis
Advanced analytics can evaluate transaction behavior in real time, flagging anomalies based on IP address, access patterns, and historical behavior. With today’s existing technology, high-risk activities can be flagged or blocked in real time.
Validate Payments Before They Move
Controls like Positive Pay help prevent check fraud, while pre-validating ACH details help organizations avoid sending funds to altered or fraudulent accounts. This is a critical step for RTP and FedNow payments, where recovery options narrow quickly or disappear entirely.
Continuously Verify Vendors
Attackers frequently target vendors as an entry point, exploiting outdated records, unverified banking changes, and informal change requests to redirect payments. Know Your Business/Vendor (KYB/KYV) processes are essential in validating vendor identities that helps prevent BEC schemes and account takeovers before fraudulent payments are initiated.
Why Fragmented Defenses Don’t Survive
As transaction volumes grow and attack methods continue to evolve, payment fraud in healthcare is less a question of “if” and more of a question of “when.” Disconnected systems and manual processes create gaps that attackers are increasingly skilled at exploiting.
A more connected, integrated approach helps healthcare organizations reduce complexity, strengthen controls, and build confidence across the entire payment lifecycle. With the right infrastructure and safeguards in place, hospitals can significantly reduce exposure and move payments forward with greater security and confidence.
The Benefits of an Integrated System
MEDITECH Alliance partner ECHO offers an integration with Expanse that was designed so payment operations remain inside the environment finance teams use every day. Payment data flows automatically from MEDITECH to ECHO and back again, allowing hospitals to initiate, track, and reconcile payments without leaving their familiar workflow.
Payment processing requires a rigorous security environment. Once a payment enters ECHO’s network, it’s evaluated through ECHOGuard; a real-time, multi-layered fraud prevention framework that applies more than 80 automated checks across identity, account validity, and transaction behavior.
The right technology can create a protective layer around the entire payment lifecycle while removing opportunities for human error through automated workflows. The result is a payment process that feels native to MEDITECH, while benefiting from the scale, healthcare-specific expertise, and fraud defenses of ECHO.
As a trusted MEDITECH Alliance Partner, ECHO’s integration with MEDITECH Expanse helps simplify and secure payments while reducing risk and operational burden. Learn more or continue the conversation on our Product Page.
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