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Hosts: Shannen Reyes-Aguayo & Nyleen Flores

Is UnitedHealthcare having the worst year in corporate history? 📉

From the tragic assassination of CEO Brian Thompson to a DOJ antitrust investigation and the massive Change Healthcare cyberattack, the spotlight is burning hot. But today, we are looking past the headlines to the systematic business practices sparking public outrage.

In this episode, Shannen & Nyleen break down the "Deny, Delay, Defend" strategy—now weaponized by AI. 

🔥 In this episode, we cover:

• 🤖 The Rise of AI: How UnitedHealthcare uses AI to deny.
• 🏥 The Human Cost: Why "Deny, Delay, Defend" isn't just about paperwork anymore; it’s about squeezing profits from Medicare Advantage patients who can't fight back.
• 👮 The Legal Storm: A look at the DOJ investigation and the class-action lawsuits piling up against the healthcare giant.

Tune in to understand exactly how the algorithm works against you. 🎧

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

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Hosts: Shannen Reyes-Aguayo & Nyleen Flores

🔥This is a  BONUS UPDATE. It’s a full-blown class action. After their CEO's murder, United Healthcare executives allegedly misled their own investors by hiding critical policy changes. When the truth finally hit, the stock dropped 22.4% , wiping out $119 BILLION in a single day.

In our bonus short "Murder, Money, and Medicare Madness," we're spilling the tea on the corporate chaos and what it means for the providers on the ground.

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

Guest: Emily Brinkman, Esq. – Healthcare Attorney
Hosts: Shannen Reyes-Aguayo & Nyleen Flores

What happens when the system built to protect patients… looks the other way?

In this episode of Credentialing Chronicles, Shannen and Nyleen sit down with powerhouse healthcare attorney Emily Brinkman to dissect how dangerous doctors slip through the cracks — and why the people who could stop them, often don’t.

From sealed investigations and “no comment” statements to hospitals paralyzed by politics, Emily pulls back the curtain on a culture that prizes silence over safety. With 20+ years in the trenches — representing hospitals, medical staffs, and even the boards themselves — she exposes the cracks that start small and end in catastrophe.

💥 Inside this episode:

• The red-flag silence that keeps patients in the dark
• Confidentiality laws that protect the wrong side
• How retaliation and reputation shape medical decisions
• What MSPs can actually do when leadership won’t listen
• Why transparency is healthcare’s most powerful disinfectant

🎧 “When the System Looks Away” is a gripping look at accountability gone missing — and a reminder that in healthcare, silence isn’t neutral. It’s dangerous.

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

Malpractice. Disfigurement... A surgeon's dead wife. A state of emergency.

This week on Credentialing Chronicles, Shannen & Nyleen investigate the horrifying case of Dr. Ben Brown, a Florida plastic surgeon whose practice was declared an "immediate, serious danger to the public."

From a patient's post-surgical wound resembling a "ribeye laying on my stomach" to a "total collapse of judgment" that left his own 33-year-old wife dead after procedures in his clinic, this isn't just malpractice. It’s a terrifying, systemic failure of oversight, accountability, and basic medical ethics.

🔥 In this episode:

• What investigators found inside the "dirty, poorly maintained" and unregistered office.
• The chilling timeline of the surgeon's wife's death—from mixing her own anesthesia to the 20-minute delay in calling 911.
• How patients who explicitly declined procedures allegedly woke up with them anyway, leading to disfigurement and necrosis.
• Why "Hillary's Law," a bill filed to stop surgeons from operating on family in an office setting, died in subcommittee.
• The critical verification steps (ABPS, AAAASF, TJC) every patient and credentialing pro must use to spot the red flags.

🧾 With a surgeon still licensed to practice (under supervision) after being deemed an "immediate, serious danger," this isn’t just a headline—it’s a wake-up call.

If you work in credentialing, medical board oversight, risk management, or patient safety, this episode proves: you are the last line of defense.

🎧 Listen now — and don’t forget to share, tag your compliance crew, and make some noise.

An "absence of evidence is not evidence of absence" on a practitioner's record.

#CredentialingChronicles #PatientSafety #MedicalMalpractice #PlasticSurgery #DrBenBrown #Credentialing #BoardCertification #Oversight #HealthcarePodcast #Florida

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

When nursing home residents die after being left in filth and pain, 18 staff members end up charged—felony neglect, falsified records, obstruction, and more. The Attorney General calls it elder abuse; the facility calls it a misunderstanding. Now, with charges “nolle prossed for now,” the case isn’t closed—it’s just waiting to explode.

Credentialing Chronicles brings you this bonus minisode: the red flags, the records, and the real fallout when care collapses and compliance fails.

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

Paid to Prescribe? 

Following the Sunshine Money: The $13.18 Billion Transparency Act

 THE RECEIPTS ARE PUBLIC!  Every year, billions of dollars flow from pharmaceutical and medical device companies to doctors. Is your physician one of them?

Shannen and Nyleen crack open and expose the massive, $13.18 BILLION network of financial ties that are now public record. Prompted by a shocking personal story, the hosts guide you through the CMS Open Payments data (openpaymentsdata.cms.gov) —the ultimate tool for accountability.

We break down the three crucial categories of influence—from General Payments (free lunches and speaking fees) to Ownership Interests (stock in the company whose products they prescribe) —and discuss the ethics of these relationships.

Don't let what you don't know hurt you. 

Listen now to learn how to search your doctor and take control of your healthcare decisions!

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

Fraud. Defendants... Shell companies. Federal crackdown.

This week on Credentialing Chronicles, Shannen & Nyleen go full investigative mode on the largest healthcare fraud takedown in U.S. history — Operation Gold Rush.

From catheters moved like burgers on a grill to braces billed for amputees, we’re exposing how Medicaid fraud has evolved into an industrialized business model. This isn’t fringe crime — it’s organized, automated, and devastating to the patients Medicaid was meant to protect.

🔥 In this episode:

• Why the OIG is now posting fraud busts on LinkedIn (and what that says about public deterrence)
• The infamous “1,000 leg braces” scheme — and how it slipped through the system
• How Operation Gold Rush raked in billions through stolen identities and shell suppliers
• What keeps DME fraud thriving (and why enforcement can’t keep up)
• The tools compliance, billing, and credentialing pros can use to stop the next scam before it starts

🧾 With $1.4B recovered and $14.6B exposed, this isn’t just a headline — it’s a wake-up call.
If you touch Medicaid oversight, healthcare billing, or credentialing, this episode proves: you’re part of the fix.

🎧 Listen now — and don’t forget to share, tag your compliance crew, and make some noise.
Fraud doesn’t hide anymore — and neither should your defenses.

#CredentialingChronicles #HealthcareFraud #OperationGoldRush #OIG #Compliance #MedicaidFraud #Credentialing #FraudPrevention

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

When the FBI comes knocking… and the Board of Medicine hits snooze.

This week, Shannen and Nyleen dive into a gut-wrenching case out of Michigan that left them both sick to their stomachs. A family medicine doctor—trusted to care for entire families—was arrested in an FBI sting operation after allegedly trying to arrange a sexual encounter involving a child.

🚨 The twist? The sting started in June 2025, the arrest happened in September, and yet—the doctor’s medical license remains active and unrestricted.

Join the Credentialing Chronicles duo as they break down how this happened, where the oversight failed, and why federal agents seem to act faster than the boards that are supposed to protect patients.

This episode is heavy, disturbing, and not for minors—but it’s a story that has to be told.

💥 In this episode:

• FBI vs. Medical Board: Who moves faster when danger’s involved?
• The shocking details of Dr's arrest
• How hospitals respond (or don’t) when a physician turns criminal
• Why the “pause button” on medical licenses must be real and immediate
• PSA for patients, physicians, and MSPs on staying alert and proactive

⚠️ Trigger Warning:

This episode contains discussions of child exploitation and criminal behavior that may be disturbing to listeners.

🗣️ PSA Takeaway:

“Innocent until proven guilty? Absolutely.
 But licensed until proven dangerous? Nope.
 The pause button on medical licenses has to be real—and immediate.”

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

Everything’s bigger in Texas — including the credentialing drama!

☕ Grab your coffee—or sweet tea if you’re feelin’ southern—and get ready for a Texas-sized laugh with a side of truth.

#CredentialingChronicles #TeaSpillinMSPs #TexasEdition #MedicalStaffProfessionals

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...

Send us a text

In this quick 5-minute sip, our MSP from sweet Georgia pours a little southern-style tea about what really goes down behind the scenes in credentialing. From lost paperwork to last-minute provider meltdowns—nothing’s off the record (except, of course, the actual records 😉).

Grab your sweet tea, sit back, and get ready for a dose of MSP reality—Georgia edition.

#CredentialingChronicles #TeaSpillinMSPs #GeorgiaMSP #MedicalStaffProfessionals

Support the show

Resources Mentioned:

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🔎 Verify Your Doctor’s Credentials

✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/

✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

For Medical Staff Professional:

✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/

✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.

✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts

🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Because credentials do matter. 🩺✨

🌐 Connection Zone
Stay plugged in...