The F Files
Welcome to The F Files, your front-line resource for tackling healthcare fraud, waste, abuse, and error. Each episode dives into real-world schemes, emerging trends, and investigative insights from the experts working to protect payment integrity. Whether you're in SIU, compliance, or analytics, you'll get practical takeaways to help you detect faster, prevent smarter, and stay ahead of fraud. Powered by Healthcare Fraud Shield. Because detecting the truth is what we do.
Episodes
Just in time for spooky season, The F Files is uncovering the mysteries of psychotherapy documentation and coding! From suspicious session times and missing interventions to unclear treatment goals and incomplete progress notes, our team explores common audit findings and the red flags reviewers should watch for.
Tune in for practical insights, real-world examples, and a little Halloween humor as we examine what it takes to properly...
In Part 2 of our SIU Roundtable, we explore how Medicare, Medicaid, and commercial payers approach fraud investigations when claims and schemes cross payer lines. Hear real-world perspectives on coordination of benefits, investigative responsibilities, communication gaps, and why collaboration matters in the fight against fraud, waste, and abuse.
Same mission. Different playbooks.
In this episode of The F Files, we bring together investigators from vendor, payer, and government environments to compare how fraud investigations really work. From leads to outcomes, hear how perspective shapes every step. Part 2 coming soon.
Too-good-to-be-true promises often hide the biggest fraud schemes. In this episode, Mandi and Daphne explore the “pot of gold” illusion in fraud, from leprechaun folklore to the real-world deception behind the Theranos scandal. The episode also features a conversation with HCFS team member Paula about HCFSElevate, the upcoming user conference in Austin, where guest speaker and whistleblower Tyler Schultz will share the ...
From bloodletting and Botox to ghost doctors and falsified lab codes, this episode exposes the dark side of "wellness" clinics and concierge med spas. Join hosts Daphne Krout and Mandi Cook as they uncover firsthand accounts of risky procedures, insurance manipulation, and outright fraud. Featuring a special guest RN turned fraud fighter who shares what really happened behind closed doors.
Non-emergency transport might sound routine, but it's become a hotspot for fraud. In this episode of The F Files, hosts Daphne and Mandi dig into schemes involving falsified mileage, upcoded services, and even transport crews lacking certification. From bizarre van rides to six-figure fraud cases, they reveal how something as simple as a ride to dialysis can turn into a $6 million scam. Whether you're in SIU, compliance, or analyti...
Phantom providers haunt healthcare systems — billing for services never rendered, using identities that don’t exist. In this episode, hosts Daphne Krout and Mandi Cook pull back the sheet on these ghostly schemes and reveal how SIUs and analytics teams can expose the fraud behind the facade.
In this special handoff episode, EVP Karen Weintraub passes the torch to our new hosts and shares what’s ahead for the Healthcare Fraud Shield podcast - including a new identity!
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 wil...
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 ...
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 FW...
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, me...
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 le...
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.co...
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 ...
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/messa...
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.hcf...
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.co...
Popular Podcasts
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Listen to 'The Bobby Bones Show' by downloading the daily full replay.
The official podcast of comedian Joe Rogan.
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.