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Pour a quick cup—Shannen & Nyleen are spilling the NAMSS tea in under five minutes. ☕️🍵 

In this episode: RADIOLOGY! _ What does Samantha have to say?!

Think of this as your NAMSS power-up: fast, punchy, and ruthlessly practical. We translate guidance into real-world red flags, receipts, and quick wins—so you can walk into your next meeting sounding like you’ve got an army of auditors in your pocket. No fluff, just facts…with a little side-eye. 😉

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

What happens when the people who keep hospitals safe get treated like “paper pushers”? In this episode, Shannen and Nyleen sit down with Dr. Victor Vargas—Chief Medical Officer, Certified Physician Executive, and credentialing advocate—to talk about the respect gap between physicians and Medical Staff Professionals (MSPs).

Dr. Vargas spills the tea on:

• Why MSPs are the first gate to patient safety
• A real case where falsified case logs were caught before a surgeon touched a patient
• How culture and credentialing go hand-in-hand
• The right way to staff and empower your MSO/CVO
• Why MSPs belong at the table—not against the wall

From peer review to provider onboarding, this conversation shows how collaboration between physician leaders and MSPs saves patients, protects hospitals, and builds trust.

🎙️ Credentialing Chronicles is where compliance meets conversation—and where we call out what really happens behind hospital walls.

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

When “trusted” turns toxic. In this episode, Shannen and Nyleen dig into the Washington State case of an OB-GYN whose exam room conduct sparked years of complaints, multiple lawsuits, and a formal Statement of Charges by the Washington Department of Health. We unpack how warning signs were minimized as “just the doctor being the doctor,” what “Active – Pending Enforcement Action” really means for patients, and why credentialing must look beyond a license that appears “clean.”

What’s inside

• A timeline of red flags (2005–2024) and how institutional shrugging enabled harm
• Allegations outlined by the WA DOH Statement of Charges: boundary violations, sexualized comments, humiliation of patients, and staff concerns
• The credentialing view: why “Active” ≠ safe, and how MSPs should escalate “pending” cases
• Culture as a safety tool—and how to hold the line when pressure says “push the file”
• Patient/physician/MSP PSAs you can act on today

Important note: The conduct discussed consists of allegations drawn from public filings and reporting. The physician’s Washington license status at the time of recording is Active – Pending Enforcement Action. Everyone is entitled to due process; our focus is on systems, patient safety, and credentialing accountability.

PSA

• Patients: Check license status, ask questions, and report uncomfortable encounters.
• Physicians: Your loyalty is to patients—speak up, document, and support safe culture.
• MSPs/CVOs: Track “pending enforcement,” document patterns, and advocate for immediate safeguards.

Credentialing Chronicles—where compliance meets conversation, and receipts meet reform.

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

Doctors caught in the Worst Betrayal

Two doctors. Two hospitals. Two of the darkest betrayals imaginable.

In this episode, Shannen and Nyleen expose the chilling cases of:

• A world-renowned geneticist at Cincinnati Children’s Hospital accused of hoarding over 150,000 child abuse images.
• A VA physician in Massachusetts charged with downloading CSAM—from his office inside a federal medical center.

These weren’t shadowy fraudsters. They were respected physicians—until law enforcement pulled back the curtain.

⚠️ Content Warning: This episode covers crimes involving child sexual abuse material. Not for minors and may be triggering.

👉 Credentialing Chronicles shines a light on how systems failed, why licenses stayed active, and what patients, providers, and MSPs must do to close the gaps.

Because sometimes spilling the darkest tea saves lives.

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

Behavioral health is booming—but billing it wrong can break your practice. In this episode, Shannen and Nyleen unpack the growing wave of medical groups adding therapy, psychiatry, and counseling services—only to stumble into denials, audits, and compliance nightmares.

From the basics of CPT codes and payer carve-outs, to the credentialing pitfalls that practices overlook, this episode digs into:

• What behavioral health billing really means (and why it isn’t just “a few extra codes”).
• Why urgent cares, OB/GYNs, and pain clinics keep adding BH services—and the dangerous shortcuts they take.
• Red flags that trigger payer audits, clawbacks, and fraud allegations.
• Real-world mistakes: upcoding, wrong NPIs, and billing under the wrong taxonomy.
• A step-by-step breakdown of how to credential, enroll, and bill correctly.
• The compliance mindset that keeps paperwork from turning into panic.

💡 Whether you’re a provider, a biller, or a practice administrator, this episode is your survival guide to adding behavioral health services the right way—without setting off alarms.

Takeaway: Adding behavioral health can transform care, but if you cut corners, it will catch up to you. Audit early, credential properly, and protect your providers, your patients, and your practice.

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

Behind the Scenes at Credentialing Chronicles

This week, we’re pulling back the curtain with a special retreat recap! 

Shannen and Nyleen sat down after their Credentialing Chronicles getaway to share:
✨ The big news — we’re headed to NAMSS in the big pink tent!
✨ How YOU can record live with us (no prep needed — just fun prompts).
✨ The power of MSP voices and why your stories matter.
✨ Our ask: more engagement, shares, and feedback to help this community grow.
✨ And yes… tales of waterfalls, trail mix, and lots of brainstorming.

This one’s for our loyal listeners, our fellow MSPs, and everyone who’s been asking, “How can I be part of the podcast?”

Hit play, stay credentialed, and we’ll see you at NAMSS! 💕

Sign up here!

https://calendly.com/credentialing-credentialingchronicles/10

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

Charts to Cellblocks dives into the 2025 National Health Care Fraud Takedown:

• 324 defendants.
• $14.6 billion in fraud.
• And scams so wild, you’ll question if you’re watching Netflix or the nightly news.

From international crime syndicates running billion-dollar ghost claims, to AI deepfake voice scams stealing Medicare millions, to opioid pill mills and fake wound care schemes — Shannen and Nyleen spill the tea on how the FBI, DEA, and Big Data brought them down.

Plus, don’t miss our PSA segment with warnings for patients, providers, and credentialing professionals.

Visit our website for more information: 

www.CredentialingChronicles.com

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

A Florida woman treated over 4,400 patients — all without a nursing license. How? She slipped through the cracks using someone else’s license number, blending in with scrubs, and almost got promoted before HR finally noticed.

In this episode, Shannen and Nyleen spill the tea on how it happened, why credentialing and primary source verification (PSV) matter, and what hospitals and HR can learn from this scandal. They also revisit the fake diploma scheme that put thousands of unqualified “nurses” into hospitals across the U.S.

This isn’t just gossip—it’s a wake-up call. Patient safety depends on rigorous credentialing, audits, and stopping “trust-the-badge” culture before it lands your organization in the headlines.

🔗 Receipts, sources, and resources are linked in the show notes.
 👂 Listen now and stay credentialed, not canceled.

Verify your Nurses' Credentials: 

https://www.nursys.com/

Operation Nightingale: 

https://oig.hhs.gov/newsroom/media-materials/nightingale/

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

NCQA Said Nope – CVO Edition
When NCQA says “no,” they mean no. In this brutally honest, laugh-out-loud episode, Shannen and Nyleen pull back the curtain on Credentialing Verification Organizations (CVOs) — the certified, the expired, the denied, and the ones hiding behind the term “NCQA aligned.”

From decoding NCQA statuses to real-life horror stories of outsourcing gone wrong, they’ll give you the insider checklist to vet your vendors, avoid audit nightmares, and protect your reputation. Whether you’re a credentialing pro, a health plan exec, or just curious about who’s verifying your providers, this episode is your wake-up call.

Edgy. Fun. Real. And yes, there’s plenty of tea.

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...

Send us a text

Hey Credentialing Fam 👋,

This one? Whew. It's for you. The backbone. The gatekeepers. The spreadsheet warriors. The unsung compliance pros who hold entire healthcare systems together.

It’s bold, real, and packed with truth bombs about what it actually means to be a Medical Staff Professional today.

Shannen and Nyleen get real about:

* The origin of MSPs as gatekeepers—why it mattered then, and still matters now
* Why credentialing isn’t clerical—it’s clinical, legal, operational, and strategic
* The federal oversight coming in 2028 (yep, the Death Master File is no joke)
* What leadership needs to hear about respecting the credentialing role
* Honest advice for every burned-out, overlooked, and underpaid MSP
* And a big reminder: *you’re not just pushing paper—you’re protecting lives*

*This episode is for the ones who:
   * Answer the call when an audit hits
   * Catch the expired license before it slips through
   * Are tired of being last to know, first to blame
   * Want change, recognition, and a seat at the table

Support the show

Resources Mentioned:

🔎 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 plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon

Open Payments

openpaymentsdata.cms.gov

Verify your Nurses' Credentials:

https://www.nursys.com/

🌐 Connection Zone
Stay plugged in with your peers, share res...