Payment processing has become more complex for medical practices — and more vulnerable to fraud.

Medical Economics Managing Editor Todd Shryock sat down with Stephanie O’Connor, director of merchant experience at Wind River Payments, to talk about the evolving risks tied to digital payment platforms in health care

O’Connor explains how practices can unintentionally expose themselves to card testing attacks, friendly fraud and costly chargebacks when they rush to adopt trending payment tools without proper safeguards. She breaks down common red flags front office staff should recognize, why refund scams are targeting health care and how artificial intelligence (AI) is now playing a critical role in fraud detection behind the scenes.

Register now for Physicians Practice's Practice Academy event: Practice Management Track, on March 19, 2026, from 1:00 PM-5:00 PM EDT: https://registration.physicianspractice.com

Music Credits:
Chasing the Moonlight by Cephas - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 — Cold open
Why practices shouldn’t have to compromise patient experience to prevent fraud.

0:18 — Intro and Practice Academy note

1:42 — Introducing Stephanie O’Connor
Payment modernization and revenue protection.

2:17 — Why practices need a payment strategy
Balancing cost control and fraud prevention.

3:21 — The biggest mistake practices make
Turning on new payment options without safeguards.

4:46 — Card testing attacks explained
How fraudsters use your website to validate stolen cards.

6:57 — Friendly fraud and chargebacks
When confusion turns into revenue loss.

7:55 — Who should practices call first?
Coordinating IT and payment processors.

8:18 — Patient portals and fraud risk
How AI works behind the scenes to protect transactions.

10:39 — Healthcare-specific chargebacks
Services not rendered and telemedicine disputes.

13:01 — P2 Management Minute

14:09 — Red flags for front office staff
Multiple declines, refund requests and rushed payments.

16:10 — Where fraud originates
Foreign BIN numbers and local “friendly” disputes.

17:16 — Are small practices more vulnerable?
Why size matters in fraud exposure.

18:06 — Can you protect revenue without hurting experience?
Why modern AI tools change the equation.

19:41 — Questions to ask your payment processor
What type of fraud are you actually protected against?

21:26 — Trends heading into 2026
Fraud stability, AI growth and proactive planning.

23:30 — Outro

S1 Ep128: Fraud, chargebacks and the future of medical payments, with Stephanie O’Connor of Wind River Payments

Off the Chart: A Business of Medicine Podcast

S1 Ep128: Fraud, chargebacks and the future of medical payments, with Stephanie O’Connor of Wind River Payments