Credentialing Chronicles

Send us Fan Mail 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 t...

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 bill...

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 opera...

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 L...

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. #CredentialingChron...

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) – Chec...

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...

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 Mention...

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) –...

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 #MedicalStaf...

Send us Fan Mail Ever opened a credentialing file and had to close it right back because of the doctor’s headshot? 😅 In this Tea Spillin’ Session , Allison joins Shannen and Nyleen to laugh (and cringe) through the unforgettable world of “professional” headshots — from glamour shots gone wrong to selfies that should’ve stayed in the camera roll. 📸 Because sometimes, before the verification even...

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.  This time we welcome our lovely Debbie Kesselring from Alaska!  We truly are covering all 50 states! #CredentialingChronicles #N...

Send us Fan Mail 👀 They showed up. They sat down. They spilled.  Anonymous 1 & 2 didn’t hold back at the Credentialing Chronicles tent—and why should they? MSPs rarely get a safe space. Leadership says “just get it done.” Providers forget to sign their apps. Payers take months to respond. And when it all collapses? Guess who takes the blame. That’s why Credentialing Chronicles exists.  We giv...

Send us Fan Mail Shannen & Nyleen pour a quick sip with Divya Shroff, MD, FHM , as she spills the tea on what really happens when quality, the MSO, and the CMO collide. 🍵 Dr. Shroff dives into how the Medical Staff Office is the backbone of quality reporting, why the CMO’s relationship with MSO leaders can make or break culture, and what happens when communication breaks down at the top.  Spo...

Send us Fan Mail Pour a quick cup—Shannen & Nyleen are spilling the NAMSS tea in under five minutes. ☕️🍵 In this lightning-round mini, we break down the hottest takeaways every medical staff pro should know right now ... 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/...

Send us Fan Mail  Pour a quick cup—Shannen & Nyleen are spilling the NAMSS tea in under five minutes. ☕️🍵 In this lightning-round mini, we break down the hottest takeaways!! 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 Excl...

Send us Fan Mail Pour a quick cup—Shannen & Nyleen are spilling the NAMSS tea in under five minutes. ☕️🍵 In this lightning-round mini, we break down the hottest takeaways every medical staff pro should know right now ! In this episode we break it down with Anonymous 1 and Anonymous 2  -  as they spill some tea! Support the show Resources Mentioned: 🔎 Verify Your Doctor’s Credentials ✔️ Stat...

Send us Fan Mail Pour a quick cup—Shannen & Nyleen are spilling the NAMSS tea in under five minutes. ☕️🍵  In this episode: RADIOLOGY! _ What does Samantha have to say?! Think of this as your NAMSS power-up: fast, punchy, and ruthlessly practical. We translate guidance into real-world red flags, receipts, and quick wins—so you can walk into your next meeting sounding like you’ve got an army o...

Send us Fan Mail What happens when the people who keep hospitals safe get treated like “paper pushers”? In this episode, Shannen and Nyleen sit down with Dr. Victor Vargas—Chief Medical Officer, Certified Physician Executive, and credentialing advocate—to talk about the respect gap between physicians and Medical Staff Professionals (MSPs). Dr. Vargas spills the tea on: Why MSPs are the first gate...

Send us Fan Mail When “trusted” turns toxic. In this episode, Shannen and Nyleen dig into the Washington State case of an OB-GYN whose exam room conduct sparked years of complaints, multiple lawsuits, and a formal Statement of Charges by the Washington Department of Health. We unpack how warning signs were minimized as “just the doctor being the doctor,” what “Active – Pending Enforcement Action”...

Send us Fan Mail Doctors caught in the Worst Betrayal Two doctors. Two hospitals. Two of the darkest betrayals imaginable. In this episode, Shannen and Nyleen expose the chilling cases of: A world-renowned geneticist at Cincinnati Children’s Hospital accused of hoarding over 150,000 child abuse images. A VA physician in Massachusetts charged with downloading CSAM— from his office inside a federal...

Send us Fan Mail Behavioral health is booming—but billing it wrong can break your practice. In this episode, Shannen and Nyleen unpack the growing wave of medical groups adding therapy, psychiatry, and counseling services—only to stumble into denials, audits, and compliance nightmares. From the basics of CPT codes and payer carve-outs, to the credentialing pitfalls that practices overlook, this ep...

Send us Fan Mail Charts to Cellblocks dives into the 2025 National Health Care Fraud Takedown : 324 defendants. $14.6 billion in fraud. And scams so wild, you’ll question if you’re watching Netflix or the nightly news. From international crime syndicates running billion-dollar ghost claims, to AI deepfake voice scams stealing Medicare millions, to opioid pill mills and fake wound care schemes — Sh...

Send us Fan Mail A Florida woman treated over 4,400 patients — all without a nursing license. How? She slipped through the cracks using someone else’s license number, blending in with scrubs, and almost got promoted before HR finally noticed. In this episode, Shannen and Nyleen spill the tea on how it happened, why credentialing and primary source verification (PSV) matter, and what hospitals and...

Send us Fan Mail NCQA Said Nope – CVO Edition When NCQA says “no,” they mean no . In this brutally honest, laugh-out-loud episode, Shannen and Nyleen pull back the curtain on Credentialing Verification Organizations (CVOs) — the certified, the expired, the denied, and the ones hiding behind the term “NCQA aligned.” From decoding NCQA statuses to real-life horror stories of outsourcing gone wrong,...