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Send us Fan Mail New Hampshire’s Healthcare Wake-Up Call A provider can be qualified, credentialed—and still out of reach. A provider’s identity can be legitimate—and still be used to submit fraudulent claims. Who is checking what happens next? In this New Hampshire edition of Credentialing Chronicles, Shannen Reyes-Aguayo and Nyleen Flores connect the headlines to the provider files, payer decisions, and patients caught in the middle. We examine the state’s 30-day mental-health credentialing reform and ask the question behind the deadline: Does faster approval actually lead to timely care and payment? From application completeness to effective dates and denied claims, we unpack where a promising policy can stumble in practice. Then we turn to rural clinic closures, Medicaid coverage challenges, and a federal prosecution tied to an alleged healthcare fraud scheme involving stolen patient and provider identities and nearly $3 billion in intended losses. Inside this episode: The 30-day credentialing clock: What teams need to track beyond an approval.Rural healthcare under pressure: What happens when a community loses a place to receive care.Provider identity theft: Why a valid license and NPI do not tell the whole story.The screening gaps: How owners, billing vendors, and other people outside the clinical roster can affect compliance.Practical incident drills: Questions to ask when claims deny—or unfamiliar claims appear under your name.For credentialing professionals, healthcare leaders, providers, and compliance teams, this episode asks what it takes to make access faster while keeping verification, accountability, and patient protection strong. Listen, share it with your team, and tell us: where does your process stop—at approval, or when the provider is truly ready to deliver care? Follow Credentialing Chronicles, leave a review, and send us the healthcare tea from your state. Stay credentialed, not cancelled. This episode provides education and commentary based on sources available through September 8, 2026. Criminal allegations are not findings of guilt. Verify current requirements before making operational decisions. Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Credential NetworkCredNet is the AI-native credentialing and payer enrollment platform built for credentialing serviceDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 What happens when the person trusted to heal the patient… is the person harming them? This week on Credentialing Chronicles, Shannen Aguayo-Reyes and Nyleen Flores sit down with Bruce Sackman, renowned healthcare fraud investigator, author, and former Special Agent in Charge with the U.S. Department of Veterans Affairs Office of Inspector General. For more than three decades, Bruce stepped into healthcare environments after something had gone terribly wrong—investigating fraud, corruption, false claims, theft, patient assault, drug diversion, suspicious hospital deaths, and some of the most disturbing cases involving medical professionals. But this conversation isn't just about the cases. It's about the warning signs before the investigation ever begins. Bruce takes us behind the investigation: what his instincts noticed before the evidence caught up, the case that permanently changed the way he viewed healthcare, the responsibility investigators carry long after a case closes, and what the public may never fully understand about investigating someone entrusted with patients' lives. And we ask the question healthcare can't afford to ignore: Have we actually gotten better at recognizing dangerous providers—or have technology, fragmented systems, staffing pressures, and endless box-checking simply created new places for the warning signs to hide? This is more than true crime. It's healthcare. It's patient safety. And it's a conversation every medical staff professional, healthcare leader, provider—and patient—needs to hear. 🎙️ Credentialing Chronicles Stay credentialed, not cancelled. Credential NetworkCredNet is the AI-native credentialing and payer enrollment platform built for credentialing serviceBaton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.HST PathwaysOne Complete Solution for Your Surgery Center’s Success From scheduling to billing, manage your entDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 This week, Credentialing Chronicles sits down with Matthew Jansen, President & CEO of Acorn Credentialing Solutions, for an exclusive conversation about the side of healthcare credentialing most people never hear about. Acorn works across credentialing, enrollment, provider data, automation, and provider operations—connecting pieces of the process that healthcare organizations have historically managed across separate systems and workflows. Acorn But we're not here for the sales pitch. Shannen and Nyleen put Matthew behind the mic for a real conversation about credentialing, technology, the problems our industry keeps running into, and where healthcare is actually headed. What happens when credentialing doesn't work the way it's supposed to? Where does technology really help—and where does the human side still matter? And when you put two credentialing professionals across from the President & CEO of a credentialing technology company... what gets said when nobody is reading from a script? 👀 Some questions were expected. Some answers weren't. No rehearsed corporate talking points. No fluff. Just credentialing professionals talking credentialing — real talk, real experience, and no filter. ☕️ You'll have to press play for the rest. Credentialing Chronicles x Acorn Credentialing Solutions 🎙️ Stay Credentialed, Not Cancelled. The tea is officially on the table. Learn more about Acorn Credentialing Solutions --https://acorncredentialing.com/ Acorn CredentialingAutomated tasks, streamlined digital workflows, advanced data management. Simple integration with leDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 The wait is over! 🎙️ We’re officially kicking off the road to NAMSS 2026, and this episode is one you do NOT want to miss. In this special announcement episode, we’re pulling back the curtain on what’s ahead for NAMSS 2026 — the excitement, the vision, the opportunities, and what you can expect as we get closer to this year’s biggest moments in the medical staff services community. Whether you’re a seasoned MSP, new to the profession, preparing for NAMSS 2026, or simply passionate about the future of medical staff services, this episode is your official starting point. The countdown starts NOW. ⏰ 🎧 Press play, turn it up, and join us as we kick off the journey to NAMSS 2026! NAMSS 2026 is coming — and we’re ready. Are you? 🚀 Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Credential NetworkCredNet is the AI-native credentialing and payer enrollment platform built for credentialing serviceDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 Big Sky. Big money. BIG oversight questions. ☕🔥 Credentialing Chronicles is Spillin’ the tea across America—and this stop takes us to MONTANA. From Medicaid changes and millions in rural health funding to provider mobility, hospital oversight, a story update and a licensing case that raises serious questions about how critical information moves through the system. Because a clean license is only the beginning. 🎙️ Grab your tea. Montana has receipts. Stay credentialed, not cancelled. 💗🖤 Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Nimble:Surgical Revenue cycle ManagementAccelerate growth. Leverage intelligent analytics. Achieve powerful financial results.HST PathwaysOne Complete Solution for Your Surgery Center’s Success From scheduling to billing, manage your entAdvanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 The internet saw the posts. The screenshots went viral. But we wanted to know: what actually happened — and how did so many red flags seemingly go unnoticed for so long? 👀☕️ In this episode of Credentialing Chronicles, Shannen and Nyleen go beyond the viral headlines and take a deeper look at the story involving Angel Murdock and claims surrounding Duke University’s Physician Assistant program. We’re breaking down the timeline, the online presence, the claims that captured people’s attention, the questions that followed, and the details that turned this into a viral conversation. But this episode isn’t just about internet drama. It raises a much bigger question. We dig into the backend of the story and examine it through the lens of credentialing and verification — including the potential warning signs, inconsistencies, and opportunities for questions that may have warranted a closer look. We’re talking about: * The timeline behind the viral story and how it unfolded * The Duke University PA program claims at the center of the controversy * The public-facing information and representations that fueled the story * The red flags and inconsistencies that raised questions * Why assumptions are NOT verification * The difference between someone saying something and independently confirming it * What credentialing professionals can learn from situations like this * Why dates, education history, professional titles, documentation, and source verification matter * How social media can make an unverified claim feel legitimate simply because it has been repeated enough times * The bigger patient-safety and healthcare implications behind proper verification Because in credentialing, “it looks right” is never the same thing as “it was verified.” This is exactly why Medical Staff Professionals, credentialing professionals, employers, healthcare organizations — and even patients — should understand the importance of asking the next question. Where did the information come from? Can it be independently verified? Do the dates make sense? Does the source support the claim? And when something doesn’t add up… who is responsible for stopping and looking closer? This episode takes the viral conversation and turns it into a real-world credentialing lesson about verification, accountability, documentation, and the red flags that can be missed when people assume instead of verify. 🎙️ Credentialing Chronicles Podcast Spillin’ the tea on the doctors — and healthcare stories — you see. Stay Credentialed, Not Cancelled.™ Listen, follow, rate, and share Credentialing Chronicles on your favorite podcast platform. ⚠️ Episode Note: This episode discusses publicly available information, online claims, reporting, and commentary surrounding a viral story. Allegations, disputed claims, and unverified statements are discussed as such. Our discussion and analysis are for educational and commentary purposes and should not be interpreted as findings of wrongdoing by any individual or institution. 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 MISSOURI: SHOW ME THE CREDENTIALS, THE AUTHORIZATION—AND THE MONEY  The Show-Me State came with RECEIPTS.  This week on Credentialing Chronicles, Shannen & Nyleen are spillin’ the Missouri tea—from alleged fake nursing credentials and the importance of primary-source verification to prior authorization chaos, rural hospitals under pressure, patient portal privacy concerns, and major healthcare changes MSPs need to have on their radar. We’re asking the questions every healthcare organization should be able to answer: ☕ Did you verify it from the SOURCE? ☕ Is the provider actually enrolled? ☕ Does an authorization guarantee payment? ☕ Who knows what your patient portal is sharing? ☕ And when staffing gets desperate… are your credentialing standards holding strong? Missouri said SHOW ME—and we’re showing the receipts. 🎙️ Credentialing Chronicles: Spillin’ the Tea Across America Educational commentary only. Allegations discussed remain allegations unless otherwise established through final legal proceedings. Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 What if the credential checked out… but the story behind it didn’t? Mississippi takes us into one of the wildest intersections of healthcare fraud, patient safety, licensed professionals, and credentialing gaps we’ve covered yet. What starts with a seemingly legitimate corner of healthcare quickly opens the door to something much bigger. Follow the trail long enough and physicians, nurses, nurse practitioners, pharmacies, federal healthcare programs, correctional healthcare, and millions upon millions of dollars begin crossing paths. But this episode isn’t just about fraud. It’s about "what the credential allows someone to do once we’ve verified it." When does a provider’s signature stop being clinical judgment and become something else? What happens when a license looks clean, but the complete story is far more complicated? Who is responsible when healthcare professionals are technically credentialed—but the systems surrounding them fail to communicate? And how many warning signs can exist in separate systems before someone finally puts them together? Then the episode takes a turn. We move from following the money to a case where the stakes become devastatingly human—and suddenly the conversation about scope, supervision, staffing, oversight, and credentialing isn’t theoretical anymore. And just when it feels like we’ve reached the end of Mississippi’s story… another layer appears. We’re breaking down the cases, the credentialing implications, the regulatory gaps, and the Mississippi-specific rules every credentialing professional should have on their radar. Because sometimes the most dangerous file isn’t the one covered in red flags. It’s the one that looks clean enough to close. Stay credentialed, not cancelled. 🎙️☕ In This Episode: 💰 When a legitimate healthcare service becomes the vehicle for something much bigger — and the reimbursement structure that helped make it possible. ✍️ The power behind a provider's signature — and why “I only signed it” may carry far more weight than it sounds. 🚩 The warning signs that can exist before criminal charges — and the uncomfortable question of who should be connecting those dots. 🏥 A devastating correctional healthcare case that shifts the conversation from money to patient safety, raising serious questions about staffing, supervision, scope, and accountability. 🔍 The “active license” problem — why an active, unrestricted license doesn't necessarily tell you the complete story behind a provider. 🔗 What happens when credentialing, claims, quality, compliance, and fraud teams operate in silos — and what organizations may miss when nobody is looking at the full picture. 📋 Mississippi-specific credentialing and regulatory considerations — including disciplinary history, telehealth requirements, reinstatement, and documented gaps within the state's fraud-reporting infrastructure. Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 Arrested. Released. Arrested Again. — The Nitun Ahir Story What happens when someone allegedly practices medicine without a license, gets arrested, is ordered to stop — and somehow ends up facing allegations of doing it again? This week on Credentialing Chronicles, Shannen and Nyleen unpack the shocking Nitun Ahir case out of California and the questions it raises about healthcare credentialing, verification, oversight, and patient safety. We’re looking beyond the headline to discuss how alleged credential discrepancies can go unnoticed, why ongoing verification matters, the warning signs healthcare organizations can’t afford to overlook, and what can happen when the systems designed to protect patients have gaps. It’s a case filled with questionable credentials, serious allegations, multiple arrests, and one major credentialing question: how did it get this far? You’ll have to press play for the full story. 🎙️ Credentialing Chronicles — Spilling the Tea, One Credential at a Time. This episode discusses allegations based on publicly available court records and law enforcement information. Allegations are not findings of guilt unless otherwise stated. This content is for informational purposes only and does not constitute legal advice. 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 What Insurance Companies Are Really Telling Doctors Prior authorization is supposed to help manage healthcare costs and ensure appropriate care. But what happens when the process becomes a barrier between doctors and their patients? In this episode of Credentialing Chronicles, Shannen and Nyleen take a closer look at what the newly published data is revealing about prior authorization — including denial rates, appeals, retrospective denials, and the administrative burden placed on physicians and their teams. We’re looking at the numbers coming out of Georgia, what they mean for providers and patients, and why transparency may be changing the conversation around insurance denials. And there’s one statistic you’ll want to hear: 82% of appealed prior authorization denials are overturned. So why are so few denials actually appealed? 🎧 Listen to this week’s episode of Credentialing Chronicles and hear what the data is really telling doctors. If this episode makes you think of a provider, credentialing professional, or healthcare colleague who needs to hear it, share it with them — and don’t forget to follow Credentialing Chronicles for more healthcare tea. ☕️ Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Nimble:Surgical Revenue cycle ManagementAccelerate growth. Leverage intelligent analytics. Achieve powerful financial results.Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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...

In this VIP episode, Shannen and Nyleen break down payer credentialing, primary source verification, facility credentialing, delegated credentialing, and the one everyone forgets: privileging. Each answers a different question, involves different decision-makers, and protects against a different kind of risk. We’re getting into the mistakes even experienced healthcare professionals make—like assuming “credentialed” means enrolled and ready to bill, believing payer approval grants hospital access, or treating credentialing and privileging as the same thing. They aren’t—and confusing them can lead to overpromising clients, undervaluing your work, delayed reimbursement, and serious compliance gaps. This isn’t textbook credentialing. It’s the real-world explanation—with insider commentary, practical examples, and the tea only industry veterans can spill. Subscribe to unlock the full episode and finally understand what people actually mean when they say, “The provider has been credentialed.”

Send us Fan Mail Special Series | Who Audits the Auditor? We've sat behind these microphones breaking down healthcare fraud, credentialing failures, compliance mistakes, and the lessons organizations can learn from them. This time... the file is ours. In this special series, the roles are reversed as AQC President Shannen opens the door to one of the hardest conversations of her career following an NCQA survey that changed everything. What happens when the person who audits everyone else has to sit in the hot seat? How do you tell your clients? Your staff? Yourself? And what's the difference between knowing something happened... and actually being able to prove it? This isn't a redemption story. It's a real-time look at leadership, accountability, credentialing, documentation, and what it takes to rebuild when every decision is under a microscope. Along the way, we unpack: ☕ The four findings that changed everything. ☕ Why documentation—not assumptions—can make or break an accreditation. ☕ The cost of one missed submission. ☕ Leadership, transparency, and what happens after the audit ends. No client files. No sugarcoating. No edited version of the truth. Just one organization choosing to share the journey while it's still unfolding. This is only the beginning. The outcome hasn't been written yet... and neither has the next chapter. 🎧 Listen now, and follow along as this story continues to unfold—because sometimes the biggest lesson isn't in the audit itself... it's in what happens next.  Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Nimble:Surgical Revenue cycle ManagementAccelerate growth. Leverage intelligent analytics. Achieve powerful financial results.MedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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...

Welcome to the inner circle. We're Shannen Aguayo and Nyleen Flores, and we're so grateful you've chosen to support Credentialing Chronicles. As a subscriber, you'll get exclusive access to bonus episodes, behind-the-scenes conversations, extended interviews, early access to select content, and real stories from the front lines of healthcare credentialing that we can't always share publicly. Whether you're a credentialing specialist, medical staff professional, provider enrollment expert, practice administrator, healthcare executive, or simply someone who wants to better understand how healthcare really works behind the scenes, you're in the right place. Here, we don't sugarcoat the challenges. We spill the tea on payer issues, accreditation, compliance, contracting, audits, denials, credentialing disasters, and the victories that keep patients getting the care they deserve. Most importantly, your subscription helps us continue creating honest, educational, and entertaining content for the credentialing community. Thank you for believing in our mission. Now grab your coffee, settle in, and welcome to the VIP side of Credentialing Chronicles—where we're always spilling the tea across America.

Send us Fan Mail Murder. Medicaid fraud. A $250 million pandemic scam. Federal investigations. Thousands of providers removed from Medicaid. No... this isn't the plot of a Netflix series. It's Minnesota. This week on Credentialing Chronicles: Spillin' Tea Across America, we're uncovering one of the most shocking collections of healthcare scandals we've seen in a single state. From an emergency room nurse practitioner convicted of murdering his secret girlfriend after allegedly abusing his prescribing authority... to one of the largest COVID-era fraud schemes in U.S. history... to sweeping Medicaid investigations that forced Minnesota to completely overhaul its provider enrollment process—this episode is packed with stories that will leave you asking, "How did this happen?" In this episode, we spill the tea on: ☕ The disturbing murder case involving a nurse practitioner, an extramarital affair, ethical violations, and questions surrounding professional boundaries in healthcare. ☕ How prescribing medications to someone with whom you have a personal relationship can quickly become a credentialing and licensing issue. ☕ The infamous Feeding Our Future scandal, where more than $250 million intended to feed children during the COVID-19 pandemic was allegedly stolen through fake meal sites, fraudulent enrollment, and fabricated documentation. ☕ Massive Medicaid fraud involving Personal Care Attendant (PCA) agencies, phantom services, fake billing, and millions of taxpayer dollars. ☕ Why the federal government threatened Minnesota's Medicaid funding and demanded immediate corrective action. ☕ Minnesota's unprecedented provider revalidation initiative that resulted in more than 18,000 providers being removed from Medicaid enrollment while thousands more underwent enhanced screening, background checks, and site visits. ☕ The credentialing, provider enrollment, compliance, and patient safety lessons every healthcare organization should take away from these cases. As always, Shannon and Nyleen break down each case through the lens of credentialing, provider enrollment, compliance, peer review, patient safety, and healthcare operations, explaining not only what happened, but how stronger credentialing practices may have helped detect warning signs sooner. Whether you're a credentialing professional, medical staff leader, healthcare executive, compliance specialist, provider enrollment expert, or simply fascinated by unbelievable true healthcare stories, this is one episode you won't want to miss. Because sometimes the biggest threats to patient safety don't begin in the exam room... They begin long before a provider ever treats a patient. Grab your favorite drink, settle in, and join us as we spill the tea across Minnesota. 🎙️ Stay credentialed, not cancelled. ☕💗 Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Nimble:Surgical Revenue cycle ManagementAccelerate growth. Leverage intelligent analytics. Achieve powerful financial results.MedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Advanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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 Missed an episode? Need to catch up? Or just want to relive the wildest moments of the year so far? This one's for you. Welcome to our Spillin' Tea Across America: Summer Rewind—a special compilation episode featuring the biggest moments, most unbelievable cases, hottest healthcare headlines, funniest conversations, listener favorites, and unforgettable lessons from our journey across America... all in one episode. After covering 23 states across America so far, we're hitting rewind on the cases, conversations, breaking news, and biggest moments you won't want to miss , our all in one special. Along the way, we'll revisit: ☕ The healthcare scandals everyone was talking about. ☕ Patient safety stories that left us speechless. ☕ Medical fraud, fake diagnoses, unnecessary treatments, kickback schemes, and physician misconduct. ☕ Credentialing updates, industry news, and healthcare headlines. ☕ Some of our favorite educational moments and credentialing tips. ☕ Behind-the-scenes laughs and unforgettable reactions. ☕ Highlights from our LIVE Spillin' Tea Across America shows in Iowa/Nebraska and Oklahoma. ☕ And the stories that had thousands of listeners saying, "There's NO way that's real." Whether you've listened to every episode or you're brand new to Credentialing Chronicles, this Summer Rewind is the perfect place to jump in. Think of it as your greatest hits album—the best stories, biggest lessons, and hottest tea we've spilled so far, all wrapped into one binge-worthy episode. So pour yourself your favorite drink, turn us on during your road trip, while you're cleaning, meal prepping, working out, folding laundry, or just relaxing in the sun, and catch up on everything that's made Spillin' Tea Across America one of our favorite series yet. Because if we've learned anything this year... Truth is stranger than fiction. And we're just getting started. 🎙️ Stay credentialed, not cancelled. ☕💗 Baton Health: Universal PSV in SecondsEliminate credentialing delays! Get 100% accurate, real-time license verification and monitoring.Nimble:Surgical Revenue cycle ManagementAccelerate growth. Leverage intelligent analytics. Achieve powerful financial results.HST PathwaysOne Complete Solution for Your Surgery Center’s Success From scheduling to billing, manage your entAdvanced Quality Compliance & CVOCredentialing. Contracting. Compliance. Handled. Completely. Concierge-level credentialing, payer eMedElevate SolutionsBridging the Gap Between Software and Clinical Reality E.L.E.V.A.T.E.™ your healthcare experience. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.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...