Credentialing Chronicles

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Hosted by: Shannen Reyes-Aguayo & Nyleen Flores
IG: @shannensunfloweraguayo | @nyleenfloresfam

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:

🔎 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 resources, and nev...

Send us Fan Mail

Hosted by: Shannen Reyes-Aguayo & Nyleen Flores
IG: @shannensunfloweraguayo | @nyleenfloresfam

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:

🔎 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 resources, and nev...

Send us Fan Mail

Hosted by: Shannen Reyes-Aguayo & Nyleen Flores
IG: @shannensunfloweraguayo | @nyleenfloresfam

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:

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 resources, and nev...

Send us Fan Mail

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:

🔎 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 resources, and nev...

Send us Fan Mail

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:

🔎 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 resources, and nev...

Send us Fan Mail

North Dakota is in the house spillin' some tea with the ladies! Listen in to see what being an MSP is like in this beautiful state. 

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 resources, and nev...

Send us Fan Mail

When a doctor asks you to find something he lost in the overnight resting room… you already know it’s about to get messy. 😳

In this quick Tea Spillin’ Session, Yesenia dishes the details on what really went down — and let’s just say, MSPs handle a whole lot more than credentialing. From unexpected “discoveries” to keeping your professionalism intact while holding back laughter (and judgment), this story proves MSPs are the real MVPs of hospital chaos. 🩺☕

#CredentialingChronicles #MSPTea #HealthcareStories #SpillinTea #MSPsDoItAll

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 resources, and nev...

Send us Fan Mail

In this 5-minute quick sip, Shannen and Nyleen sit down with Erica for a Tea Spillin’ Session you won’t forget. ☕

What’s the word of the day? “Bricks.”
 

Nope, not the kind you build a house with—

Short, sharp, and a little spicy—this one’s pure Credentialing Chronicles gold. 💅

#CredentialingChronicles #TeaSpillinSession #MSPTalk #NAMSS #Bricks

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 resources, and nev...

Send us Fan Mail

Are Email addresses telling?! What's the craziest email address you have seen?!  

Ashley lets us know on this tea spillin' session!

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 resources, and nev...

Send us Fan Mail

Grab your badges and your mugs—because the MSPs are spilling the JUICIEST tea from NAMSS! From wild conference confessions to “did-they-really-say-that?!” moments, Shannen and Nyleen are serving laughs, lessons, and a whole lotta credentialing realness.

On this session: Ann Klinger, Conference Committee Chair for NAMSS. 

#CredentialingChronicles #NAMSS2025 #SpillinTea #MedicalStaffProfessionals

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 resources, and nev...