Healthcare Fraud Shield

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Chesterfield, MO
Healthcare Fraud Shield

Healthcare Fraud Shield provides fraud, waste, abuse and error (FWAE) consulting services for the healthcare industry.

Our team has extensive expertise in fraud detection technology, prevention and management. Healthcare Fraud Shield provides new and unique Fraud, Waste, Abuse and Error (FWAE) automated solutions to the healthcare industry. Our exclusive data solutions and investigative expertise deliver maximum results in the detection and prevention against fraud. Leveraging our comprehensive fraud experience, w

e deliver fresh insights and new approaches to combat the largest challenge of our time - the delivery of honest, efficient and compassionate healthcare.

04/29/2026

Join us NEXT WEEK for an ACAP webinar with Karen Weintraub, EVP as she explores what’s really driving today’s documentation risk and improper payments.

📆 Wednesday, May 6
🕑️ 2:00pm ET
🔗 Register here: https://us06web.zoom.us/webinar/register/4217762718563/WN_lyzcrZ4oTg24rGLrf4IpKA #/registration

In this webinar, you will learn:
👉️ Where documentation gaps create financial and compliance exposure
👉️How to spot patterns across records, not just individual claims
👉️Practical ways to strengthen audit workflows and reviewer consistency

If your team handles audits, investigations, or payment integrity, this session will give you actionable insight you can apply right away.

04/28/2026

🚨 We want YOUR questions for our next episode of The F Files 🎙️

If you’ve worked in healthcare fraud, payment integrity, or compliance, you’ve likely asked yourself:
❓️ What’s the real difference between a Payer SIU and a State Medicaid Program Integrity (MPI) Unit?
❓️How do ZPICs / UPICs approach investigations differently?
❓️Do fraud schemes shift between Medicare, Medicaid, Medi-Medi, and Commercial plans?
❓️Where do responsibilities overlap and how can collaboration improve FWA outcomes?

We’re building an episode that gets into the real-world complexity behind these roles and programs. Not the textbook version. The version you deal with every day.

That’s where you come in. We’re looking for:
👉 Questions you’ve always had but never asked
👉 Gray areas that slow down investigations
👉 Differences that impact how you audit, investigate, or recover funds
👉 Misconceptions that need to be cleared up

Drop your questions in the comments or send a message if you prefer to share directly. Your input will shape the episode and help bring practical insight back to the community.

# FWAE

04/24/2026

Prevention > recovery. Every time.

04/23/2026

🥳 That’s a wrap on HCFSElevate 2026!

Thank you to everyone who joined us, shared insights, and contributed to the conversations that move this industry forward.

What stood out this week:
⭐️ Stronger collaboration across SIU, PI, and compliance teams
⭐️ Clear focus on reducing false positives and improving lead quality
⭐️ Real examples of measurable ROI and faster case resolution

We’re leaving energized and ready to keep building with you.

Let’s keep the momentum going and we will see you in Denver for HCFSElevate 2027!

04/22/2026

HCFSElevate Day 2 is all about sharpening strategy and putting ideas into action. 🎬

We started early with 🍳 Eggs & Ethics, digging into real investigative scenarios and compliance challenges.

👀 Today’s focus:
• The current state of payment integrity and where SIU programs are heading
• How fraud, waste, abuse, and error continue to evolve
• Practical ways to use the HCFSPlatform to track provider education and measure impact
• SIU best practices that improve outcomes across teams

These sessions go beyond theory. They show how teams are building stronger workflows, improving documentation, and driving measurable results.

If you are here, what insight are you taking back to your team? 👇

04/21/2026

Day 1 is wrapped up and the energy is real.

We are diving straight into the challenges that matter most:
• A powerful keynote from whistleblower Tyler Shultz on why fraud demands transparency
• Real-world strategies on improving case selection and lead quality
• Turning analytics and coding insight into stronger investigations
• Using the HCFSPlatform to detect patient harm, not just billing risk
• Deep dives into pharmacy investigations and emerging patterns

And this is just the start.

If you’re here, tell us your biggest takeaway so far.

04/20/2026

We’re almost there.

Tomorrow, we kick off HCFSElevate User & Industry Conference and we could not be more excited to bring this community together.

What to expect:
• Real conversations with SIU and PI leaders
• Practical strategies to strengthen fraud detection and audit workflows
• Insights you can take back and use right away

From prepay prevention to postpay recovery, this is where ideas turn into action.

Safe travels to everyone joining us. We’ll see you soon.

04/17/2026

Are you prepared for the Attack of the Clones… No, not that one.

We’re talking about cloned medical records. The kind that quietly inflate risk, distort audits, and drain resources. And unlike the movies, there’s no heroic rescue coming.

And let’s be honest… relying on Jar Jar Binks is not a strategy.

RecordPlus is built to turn messy, repetitive records into actionable intelligence and flag cloned content before it becomes a bigger problem.

Because in payment integrity, you need visibility, consistency, and answers you can trust.

May the data be with you.

04/16/2026

Join us for an upcoming ACAP webinar with Karen Weintraub, EVP as she explores what’s really driving today’s documentation risk and improper payments.

📆 Wednesday, May 6
🕑️ 2:00pm ET
🔗 Register here: https://us06web.zoom.us/webinar/register/4217762718563/WN_lyzcrZ4oTg24rGLrf4IpKA #/registration

In this webinar, you will learn:
👉️ Where documentation gaps create financial and compliance exposure
👉️How to spot patterns across records, not just individual claims
👉️Practical ways to strengthen audit workflows and reviewer consistency

If your team handles audits, investigations, or payment integrity, this session will give you actionable insight you can apply right away.

04/15/2026

Millions in avoidable losses continue across federal healthcare programs.

Through CRUSH and expanded AI oversight, CMS is shifting expectations from having controls in place to demonstrating measurable program integrity performance.

Health plans and government programs are being asked to show:

☑️ Stronger compliance controls
☑️ Documentation validation
☑️ Measurable improvement
☑️ Transparent, accountable AI

This is now an executive issue tied to funding confidence and governance visibility.

Healthcare Fraud Shield supports enterprise-wide integrity performance through integrated, AI-powered infrastructure built for defensible oversight.

Is your program integrity framework board-ready?

04/14/2026

Happy National Laugh Day 🤣 😂 🤣

Why did the SIU investigator bring a dog to the audit?

To sniff out suspicious claims.🐶

04/13/2026

🚨 Palm Line Surgery Alert
Altering life lines… billing like it’s medically necessary… and hoping no one notices.

HCFS has a different prediction:
🔮 We see an outlier…
🔮 We see peer comparison…
🔮 We see an audit in your future

Address

16052 Swingley Ridge Road Ste 200
Chesterfield, MO
63017

Telephone

+18883338140

Website

http://www.hcfraudshield.com/

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