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All Episodes - Healthcare Fraud Shield

Healthcare Fraud Shield’s fraud, waste, and abuse platform – FWAShield™  – is an integrated solution consisting of AIShield™ (AI driven anomaly detection), PreShield™ (pre-payment), PostShield™ (post-payment), our Shared Analytics across payers, RxShield™ (pharmacy analytics), CaseShield™ (case management), and QueryShield™ (ad-hoc querying tool). In this podcast we will discuss the latest trends and news in the fraud, waste, and abuse industry.

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23 Episodes

Season 4, Episode 4: Listen to Kelli Hess, Healthcare Fraud Shield's Senior Investigator thumbnail

Season 4, Episode 4: Listen to Kelli Hess, Healthcare Fraud Shield's Senior Investigator

06/06/2023 26 min 56 sec

Season 4 will be a series of interviews with members of our own Special Investigations Unit.  We will showcase different members of our team including the director, investigators, coders and clinicians who will join each episode for a fun reflective chat on their first case/various experiences and lessons learned.  In this episode, Kelli Hess who has vast experience investigating both Medicare and Commercial plan data will walk through her background in the FWA industry and one of her first experiences. If you would like more information, contact us at SIU@hcfraudshield.com

Season 4, Episode 3: Listen to Maria Seedorff, Healthcare Fraud Shield's Senior Clinical Investigator thumbnail

Season 4, Episode 3: Listen to Maria Seedorff, Healthcare Fraud Shield's Senior Clinical Investigator

04/25/2023 20 min 9 sec

Season 4 will be a series of interviews with members of our own Special Investigations Unit.  We will showcase different members of our team including the director, investigators, coders and clinicians who will join each episode for a fun reflective chat on their first case/various experiences and lessons learned.  In this episode, Maria Seedorff who has a wealth of information will walk through her background in the FWA industry and one of her first experiences. Maria is a chiropractor, a Certified Professional Coder, and Accredited Health Care Fraud Investigator and one of our FWA gurus.

Season 4, Episode 2: Listen to Ken Cole, Healthcare Fraud Shield's Director of Special Investigations  thumbnail

Season 4, Episode 2: Listen to Ken Cole, Healthcare Fraud Shield's Director of Special Investigations

03/15/2023 28 min 6 sec

Season 4 will be a series of interviews with members of our own Special Investigations Unit.  We will showcase different members of our team including the director, investigators, coders and clinicians who will join each episode for a fun reflective chat on their first case/various experiences and lessons learned.  In this episode, our Director of Special Investigations, Ken Cole will walk through his background in the FWA industry and one of his first experiences investigating cases using Healthcare Fraud Shield's platform.

Season 4: Episode 1 - Season of Firsts, our First FWA Investigations thumbnail

Season 4: Episode 1 - Season of Firsts, our First FWA Investigations

02/13/2023 15 min 56 sec

Season 4 will be a series of interviews with members of our own Special Investigations Unit.  A different member of our team of investigators, coders and clinicians will join each episode for a fun reflective chat on their first case and lessons learned.  In this first episode, our EVP Karen Weintraub will walk through her experience in her first case that contained all the key elements from data mining, onsite audits, medical record retrieval and reviews, interviews, working with attorneys, settlement, negotiation and more....

Season 3: Episode 4 - Healthcare Fraud Shield's Shared Analytics thumbnail

Season 3: Episode 4 - Healthcare Fraud Shield's Shared Analytics

08/31/2022 15 min 27 sec

Welcome to Season 3, Episode 4 of the Healthcare Fraud Shield podcast. In this episode Karen Weintraub (along with an appearance from her mighty blue macaws) will discuss our Shared Analytics initiative across clients used to detect emerging schemes, and trends for potential fraud, waste and abuse.    If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com.    Do you have any questions or podcast topic ideas or need assistance registering for our webinars?  Email us at kweintraub@hcfraudshield.com.

Season 3: Episode 3 - Travelling Physicians thumbnail

Season 3: Episode 3 - Travelling Physicians

07/20/2022 14 min 16 sec

Welcome to Season 3, Episode 2 of the Healthcare Fraud Shield podcast. In this episode Karen Weintraub will discuss travelling physicians and potential for fraud, waste and abuse.    If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: REGISTER HERE.    Do you have any questions or podcast topic ideas or need assistance registering for our webinars?  Email us at kweintraub@hcfraudshield.com.

Season 3: Episode 2 - Acetaminophen Toxicity and what Healthcare Fraud Shield is doing about it! thumbnail

Season 3: Episode 2 - Acetaminophen Toxicity and what Healthcare Fraud Shield is doing about it!

04/05/2022 15 min 30 sec

Welcome to Season 3, Episode 2 of the Healthcare Fraud Shield podcast. In this episode Karen Weintraub will describe Acetaminophen Toxicity and how FWA analytics companies such as Healthcare Fraud Shield can detect potentially harmful doses being prescribed.    If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas or need assistance registering for our webinars?  Email us at kweintraub@hcfraudshield.com.

Season 3: Episode 1 - What's new in 2022? Karen Weintraub (and her dogs) talk about new codes (modifiers, places of service and diagnosis codes). thumbnail

Season 3: Episode 1 - What's new in 2022? Karen Weintraub (and her dogs) talk about new codes (modifiers, places of service and diagnosis codes).

02/24/2022 18 min 44 sec

Welcome to Season 3, Episode 1 of the Healthcare Fraud Shield podcast. In this episode Karen Weintraub (along with some cameos from her dogs) will walk through a few new things happening in 2022 and spending a little time focusing on things other than procedure codes (modifiers, places of service, and diagnosis codes).    If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas or need assistance registering for our webinars?  Email us at kweintraub@hcfraudshield.com.

Episode 7: FWA Chat with a Retired OIG Agent thumbnail

Episode 7: FWA Chat with a Retired OIG Agent

06/29/2021 39 min 48 sec

Welcome to Season 2, Episode 7 of the Healthcare Fraud Shield podcast. In this episode we talk to Eric Rubenstein a retired OIG Agent who currently the Director of Litigation/FWA Support at Advize Health.  If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email us at kweintraub@hcfraudshield.com.

Episode 6: COVID-19 FWA Reflection thumbnail

Episode 6: COVID-19 FWA Reflection

05/11/2021 13 min 6 sec

Welcome to Season 2, Episode 6 of the Healthcare Fraud Shield podcast. In this episode we reflect on COVID-19 FWA and discuss what we thought vs. what actually happened as it pertains to FWA.  If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email us at kweintraub@hcfraudshield.com.

Episode 5: Ouch! Pain Management Coding thumbnail

Episode 5: Ouch! Pain Management Coding

04/13/2021 28 min 12 sec

Welcome to Season 2, Episode 5 of the Healthcare Fraud Shield podcast. In this episode we have a special guest, Toni Elhoms from Alpha Coding Experts who will discuss pain management coding and schemes.  If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email us at kweintraub@hcfraudshield.com.

Episode 4 - Reviewing the Basics of DRGs thumbnail

Episode 4 - Reviewing the Basics of DRGs

03/09/2021 19 min 5 sec

Welcome to Season 2, Episode 4 of the Healthcare Fraud Shield podcast. In this episode we will discuss Diagnosis Related Groups (DRGs).  If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email us at kweintraub@hcfraudshield.com.

Episode 3 - AI and the Challenges for Fraud, Waste and Abuse Detection thumbnail

Episode 3 - AI and the Challenges for Fraud, Waste and Abuse Detection

02/15/2021 27 min 12 sec

Welcome to Season 2, Episode 3 of the Healthcare Fraud Shield podcast. In this episode we will discuss AI and the Challenges for Fraud, Waste and Abuse Detection.  If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email us at kweintraub@hcfraudshield.com.

Episode 2 - Prepayment - How to save time and increase ROI.  thumbnail

Episode 2 - Prepayment - How to save time and increase ROI.

02/06/2021 11 min 52 sec

Welcome to Season 2, Episode 2 of the Healthcare Fraud Shield podcast. In this episode we will address the who, what, where, when and why of Prepayment. If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message. If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you would like to sign up for our webinars you can monitor our future webinars here: www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email me at kweintraub@hcfraudshield.com.

Episode 1 - 2021, What's New? thumbnail

Episode 1 - 2021, What's New?

01/14/2021 11 min 31 sec

This is the first episode of Season 2 and we look forward to providing exciting content in 2021.  In this episode we will review some of the new HCPCS codes for 2021.    If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message.   If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com.  If you would like to sign up for our webinar in January, go to www.tinyurl.com/hcfswebinar.    Do you have any questions or podcast topic ideas?  Email me at kweintraub@hcfraudshield.com.

Episode 7 - Evaluating a FWA Vendor thumbnail

Episode 7 - Evaluating a FWA Vendor

12/09/2020 9 min 42 sec

This episode is about the questions you want to ask yourself when evaluating a FWA Vendor.   This is the last episode of Season 1, but we look forward to providing more content in 2021.   If you would like to record a message for our podcast you can go to https://anchor.fm/hcfs/message.   If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you have any questions or would like to request a podcast on a specific topic, email kweintraub@hcfraudshield.com.

Episode 6 - Searching Smarter thumbnail

Episode 6 - Searching Smarter

11/17/2020 23 min 22 sec

This episode is about searching smarter throughout your audits and investigations.  We discuss incorporating research tools and techniques to assist in the identification of information relevant to fraud, waste and abuse.  If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you have any questions or would like to request a podcast on a specific topic, email kweintraub@hcfraudshield.com.

Episode 5 - The Good, the Bad, and the Ugly of Investigations: Part 3 - Overpayments and Recoveries thumbnail

Episode 5 - The Good, the Bad, and the Ugly of Investigations: Part 3 - Overpayments and Recoveries

11/10/2020 18 min 57 sec

This episode is a continuation of a series on the good, the bad and the ugly of investigations.  In part 3 of this series we will focus on medical overpayments and recoveries, but stay tuned for future podcasts in this series.    If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you have any questions or would like to request a podcast on a specific topic, email kweintraub@hcfraudshield.com.

Episode 4 - The Good, the Bad, and the Ugly of Investigations: Part 2 - Medical Records thumbnail

Episode 4 - The Good, the Bad, and the Ugly of Investigations: Part 2 - Medical Records

10/27/2020 21 min 2 sec

This episode is a continuation of a series on the good, the bad and the ugly of investigations.  In part 2 of this series we will focus on medical records, but stay tuned for future podcasts in this series on requesting refunds, negotiating and referrals.    If you want to learn more about Healthcare Fraud Shield's integrated FWA software solution, check out our website at www.hcfraudshield.com. If you have any questions or would like to request a podcast on a specific topic, email kweintraub@hcfraudshield.com.

Episode 3 - The Good, the Bad, and the Ugly of Investigations: Part 1 - Data Mining thumbnail

Episode 3 - The Good, the Bad, and the Ugly of Investigations: Part 1 - Data Mining

10/14/2020 30 min 55 sec

This episode is the start of a series on the good, the bad and the ugly of investigations.  In part 1 of this series we will focus on data mining, but stay tuned for future podcasts in this series on medical records/gathering evidence, requesting refunds and negotiating and referrals.    If you want to learn more about Healthcare Fraud Shield's solution, check out our website at www.hcfraudshield.com.

Episode 2 - Conducting Onsite Audits thumbnail

Episode 2 - Conducting Onsite Audits

10/06/2020 27 min 47 sec

Healthcare fraud investigators are tasked with gathering information and evidence used to disprove or prove an allegation of potential fraud, waste or abuse.  In this episode, we discuss some of our experiences with conducting onsite audits as well as tips and tricks.  Thanks for listening!

Episode 1 - A little about Healthcare Fraud Shield thumbnail

Episode 1 - A little about Healthcare Fraud Shield

09/28/2020 9 min 17 sec

This episode is an introduction to Healthcare Fraud Shield.  Learn a little about our company, what makes Healthcare Fraud Shield different and why is healthcare fraud so complicated?  Thanks for listening!  For more information, email us at info@hcfraudshield.com.

Healthcare Fraud Shield (Trailer) thumbnail

Healthcare Fraud Shield (Trailer)

09/24/2020 0 min 37 sec