Fraud is evolving faster than traditional controls. Schemes are more coordinated and documentation is more engineered. Billing patterns are designed to survive first-pass reviews. And many organizations are still reacting after payment.
If you lead SIU, compliance, payment integrity, or analytics, the question is not whether fraud is occurring. The question is: Are you learning from it fast enough?
Why We Launched The F Files
Healthcare Fraud Shield created The F Files podcast to close the intelligence gap.
Hosted by Daphne Krout and Mandi Cook, the podcast examines real-world fraud, waste, abuse, and error with one objective: Deliver actionable investigative insight for professionals protecting healthcare dollars. This is not high-level commentary, it’s field intelligence.
The Pattern We’re Seeing
Across payer organizations, we consistently observe:
- Claims that pass edits but fail context review
- Documentation that appears complete but lacks clinical alignment
- Provider identities that collapse under deeper validation
- Trends that only become visible after significant financial exposure
Improper payments remain heavily driven by documentation deficiencies and insufficient record support.¹ Fraud actors understand this. They exploit complexity, fragmentation, and delay.
What Listeners Gain
Each episode delivers:
✔ Investigative frameworks you can apply immediately
✔ Red-flag indicators grounded in real scenarios
✔ Strategic perspective for executive decision-makers
✔ Insight that bridges analytics and operational review
This is designed for professionals who need more than awareness. They need advantage.
Add It to Your Intelligence Stack
If fraud prevention is part of your mandate, The F Files belongs on your playlist.
🎧 Listen on Spotify: https://open.spotify.com/show/6qfH3TsWECZwxyAUzqptqy?si=axbOggMCTkKVEm6x4fOOqw
or find other channels here: https://www.hcfraudshield.com/podcast/
Share it with your SIU, discuss it with compliance, and use it to sharpen your detection strategy. Because fraud is adapting and intelligence must adapt faster.
¹ U.S. Government Accountability Office. Medicare Fee-for-Service Improper Payments Report.