Healthcare Fraud Shield

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

10/21/2025

🧠 Remember this number: 805
It’s not your case ID.
It’s not a billing code.
It’s where the fraud fighters hang out at NHCAA ATC 2025.

📍 Booth 805 = 8 out of 5 fraud schemes detected
(Yeah, we’re that good.)

Swing by the Healthcare Fraud Shield booth for:
✅ Live demos that actually show you something useful
✅ Real AI catching real fraud
✅ Tools your SIU will actually want to use
✅ Bonus: Terrible fraud puns and swag worth the stop

If you're serious about smarter detection and better case outcomes, stop by Booth 805. We'll make it worth your walk.

🧠 Big ideas. Real solutions. And a deep dive into healthcare’s toughest challenges.Healthcare Fraud Shield is heading to...
10/20/2025

🧠 Big ideas. Real solutions. And a deep dive into healthcare’s toughest challenges.

Healthcare Fraud Shield is heading to TAHP Texas Covered Conference + Expo in Austin, TX and we’re ready to connect! Catch Rachel Axelrod and Vanessa Morotti at Booth #415 from Nov 3–5, 2025.

Whether you're focused on payment integrity, SIU operations, or analytics, stop by to learn how our modular, AI-powered platform is helping health plans detect faster, prevent smarter, and protect every dollar.

Let’s talk fraud.
Let’s talk workflow.
Let’s talk ROI.

📍 Austin Convention Center
🗓️ November 3–5, 2025
🔎 Booth #415

🔁 Duplicate Medicare C & D Payments: The Overlap You Can’t Afford to MissCMS is sounding the alarm, urging plan sponsors...
10/20/2025

🔁 Duplicate Medicare C & D Payments: The Overlap You Can’t Afford to Miss

CMS is sounding the alarm, urging plan sponsors to address duplicate billing across Medicare Part C and Part D. These hidden overlaps between encounter and PDE records can quietly drain budgets, jeopardize compliance, and trigger audits.

🚨 Waiting for CMS to find the issue? That’s a risk you don’t need to take
🧩 Is your pharmacy and SIU team connecting the dots or operating in silos?
💻 Are your systems cross-analyzing medical and pharmacy data in real time?

RxShield from Healthcare Fraud Shield gives health plans a smarter defense by uniting C and D data to uncover what siloed systems miss.
✅ Duplicate payment detection
✅ Audit-ready insights
✅ Seamless SIU and pharmacy integration

Align with CMS, stay ahead of audits, and protect every dollar.
👉 Learn how RxShield can help: www.hcfraudshield.com



New schemes. Old logic. That’s not a battle... that’s a surrender.🏳️
10/17/2025

New schemes. Old logic. That’s not a battle... that’s a surrender.🏳️

🎙️ New name. Same mission.The Healthcare Fraud Shield Podcast is back, now as The F Files.Launching October 30, we’re ki...
10/16/2025

🎙️ New name. Same mission.

The Healthcare Fraud Shield Podcast is back, now as The F Files.

Launching October 30, we’re kicking off with a deep dive into Phantom Providers. How ghost claims haunt your payments and what to do about it.

🧠 Real insights.
💡 Real cases.
🕵️♂️ Real prevention.

👉 Follow now and get ready for episode 1: https://open.spotify.com/show/6qfH3TsWECZwxyAUzqptqy?si=axbOggMCTkKVEm6x4fOOqw



10/15/2025

📰 Did you know Healthcare Fraud Shield offers a monthly newsletter packed with FWAE insights?

If you're in SIU, payment integrity, or healthcare compliance, this isn’t your average newsletter.

🧠 Expert-written articles from industry SMEs
🔍 Scheme spotlights
📊 Tools, alerts, and AI models that help health plans act faster
🎤 Sneak peeks at our events and conferences

Whether you're a client or just committed to fighting FWAE, our newsletter helps you stay sharp, stay informed, and stay connected.

👉 Subscribe now: https://www.hcfraudshield.com/hcfs-newsletter/

🚨 Heading to NHCAA ATC 2025? So are we.📍 Visit HCFS at Booth #805We’re not just showing up. We're showing how advanced ...
10/14/2025

🚨 Heading to NHCAA ATC 2025? So are we.
📍 Visit HCFS at Booth #805

We’re not just showing up. We're showing how advanced analytics and real-time detection are reshaping the fight against healthcare fraud, waste, abuse, and error.

🎤 Catch our experts live:

🕵️Unmasking Phantom Providers
📅 Wednesday, November 19 | 1:00 to 2:00 PM
🎙️ Karen Weintraub, EVP
Learn how link analysis and external data expose fraudulent networks hiding in plain sight.

📊 Enhanced Data Analytics to Support SIU Case Development
📅 Thursday, November 20 | 4:00 to 5:00 PM
🎙️ Kenneth Cole, Director of SIU
Explore real fraud schemes across labs, SNFs, home health, and more. See how collaboration between analytics and SIU teams delivered multi-million dollar recoveries.

👀 What to expect at Booth #805:
✅ Live demos
✅ Fraud detection insights
✅ Proactive strategies for your SIU, cost containment, & payment integrity teams
✅ Scalable AI solutions with proven ROI

💬 Let’s connect and talk about how you can stay ahead of fraud schemes before they scale.


🎓 Elevate Your Expertise at !We're thrilled to announce that attendees of our HCFSElevate 2026 User & Industry Conferen...
10/13/2025

🎓 Elevate Your Expertise at !

We're thrilled to announce that attendees of our HCFSElevate 2026 User & Industry Conference can earn 7 Continuing Professional Education (CPE) credits toward their AHFI® designation. 🌟

The National Health Care Anti‑Fraud Association (NHCAA) has awarded the live program HCFS, 7 Continuing Professional Education credits towards the AHFI® designation. Granting of this approval in no way constitutes endorsement by the NHCAA of the program, content, or program sponsor.

Join your peers in SIU, payment integrity, compliance, and fraud detection for two days of cutting-edge content, real-world insights, and powerful networking.

📧 Email info@hcfraudshield.com if you're interested in attending.

📅 Save the date: April 21–22, 2026 | Austin, TX

10/10/2025

🧠 World Mental Health Day is a reminder of what truly sustains us: our people.

In the high-stakes world of healthcare fraud prevention, the pressure is real. The deadlines are tight. The work matters deeply.

But none of it works if we don't take care of each other.

At Healthcare Fraud Shield, mental health is not a box to check. It is a commitment we make — to listen without judgment, to lead with empathy, and to make space for vulnerability as a strength.

To our team, clients, and partners:
You are more than the role you play. You are human, and that always comes first.

10/09/2025

🎧 WE’RE BACK.

Our podcast returns THIS MONTH with a whole new identity:
🔍 The F Files: When claims get weird, we get to work.

Weird claims. Wild schemes. And the people who dig into the data to find what doesn’t belong.

The F Files brings together curious minds from Healthcare Fraud Shield. People who investigate the strange stuff in claims data, connect the dots, and figure out how to stop it. Each episode explores real FWAE schemes and the analytics and tools used to detect them.

🔍 Actual patterns
📊 Actionable insights
🎙️ Real talk from the front lines of fraud detection

This isn’t theory. It’s how detection actually happens.

👉 Follow now and watch the handoff episode: https://open.spotify.com/show/6qfH3TsWECZwxyAUzqptqy?si=axbOggMCTkKVEm6x4fOOqw

🙋‍♀️🙋‍♂️ SIU leaders, let’s play Have You Ever? 👀 Be honest! Which ones have you run into with your FWA software?(Commen...
10/08/2025

🙋‍♀️🙋‍♂️ SIU leaders, let’s play Have You Ever?

👀 Be honest! Which ones have you run into with your FWA software?
(Comment with your number ⬇️)

1️⃣ Needed to look up a specific procedure and compare how it’s billed?
2️⃣ Wanted to instantly see links and connections between providers and members?
3️⃣ Wished the highest-risk leads just came straight to you?
4️⃣ Hunted for exclusions, license info, and public records all in one spot?

✅ If you’ve ever said yes to any of these…
…it’s time to try Healthcare Fraud Shield — built for SIUs that want answers, not obstacles.

💬 Drop your number below or tag someone who’s been there!

10/07/2025

🎯 Heading to NHCAA ATC 2025? So are we!
Catch Healthcare Fraud Shield at Booth 805 in Nashville, TN, Nov 18–21 at the Ga***rd Opryland Resort.

Let’s talk about stopping fraud before payment using real-time alerts, AI-driven detection, and configurable workflows.

✅ Prepay fraud prevention
✅ Proven ROI
✅ Built for SIUs, payment integrity, and compliance teams

Swing by Booth 805 to see what smarter fraud-fighting looks like.

Address

16052 Swingley Ridge Road Ste 200
Chesterfield, MO
63017

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