Healthcare Fraud Shield

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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), 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.

Healthcare Fraud Shield


    • Jun 6, 2023 LATEST EPISODE
    • monthly NEW EPISODES
    • 19m AVG DURATION
    • 23 EPISODES


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    Latest episodes from Healthcare Fraud Shield

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

    Play Episode Listen Later Jun 6, 2023 26:56


    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

    Play Episode Listen Later Apr 25, 2023 20:09


    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.

    healthcare senior fraud shield investigators fwa special investigations unit clinical investigator
    Season 4, Episode 2: Listen to Ken Cole, Healthcare Fraud Shield's Director of Special Investigations

    Play Episode Listen Later Mar 15, 2023 28:06


    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

    Play Episode Listen Later Feb 13, 2023 15:56


    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....

    investigations firsts special investigations unit
    Season 3: Episode 4 - Healthcare Fraud Shield's Shared Analytics

    Play Episode Listen Later Aug 31, 2022 15:27


    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

    Play Episode Listen Later Jul 20, 2022 14:16


    Welcome to Season 3, Episode 2 of the Healthcare Fraud Shield podcast. In this episode Karen Weintraub will 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!

    Play Episode Listen Later Apr 5, 2022 15:30


    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).

    Play Episode Listen Later Feb 24, 2022 18:44


    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

    Play Episode Listen Later Jun 29, 2021 39:48


    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

    Play Episode Listen Later May 11, 2021 13:06


    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

    Play Episode Listen Later Apr 13, 2021 28:12


    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

    Play Episode Listen Later Mar 9, 2021 19:05


    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

    Play Episode Listen Later Feb 15, 2021 27:12


    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.

    Play Episode Listen Later Feb 6, 2021 11:52


    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.

    save time fwa prepayment
    Episode 1 - 2021, What's New?

    Play Episode Listen Later Jan 14, 2021 11:31


    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

    Play Episode Listen Later Dec 9, 2020 9:42


    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

    Play Episode Listen Later Nov 17, 2020 23:22


    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

    Play Episode Listen Later Nov 10, 2020 18:57


    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

    Play Episode Listen Later Oct 27, 2020 21:02


    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

    Play Episode Listen Later Oct 14, 2020 30:55


    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

    Play Episode Listen Later Oct 6, 2020 27:47


    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

    Play Episode Listen Later Sep 28, 2020 9:17


    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)

    Play Episode Listen Later Sep 24, 2020 0:37


    healthcare fraud shield trailer

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