Credentialing Chronicles

Episode 33: Deny, Delay, Defend - The United Health Fallout

• Shannen and Nyleen • Season 1 • Episode 33

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Hosted by: Shannen Reyes-Aguayo & Nyleen Flores
IG: @shannensunfloweraguayo | @nyleenfloresfam

Is UnitedHealthcare having the worst year in corporate history? 📉

From the tragic assassination of CEO Brian Thompson to a DOJ antitrust investigation and the massive Change Healthcare cyberattack, the spotlight is burning hot. But today, we are looking past the headlines to the systematic business practices sparking public outrage.

In this episode, Shannen & Nyleen break down the "Deny, Delay, Defend" strategy—now weaponized by AI. 

🔥 In this episode, we cover:

  • 🤖 The Rise of AI: How UnitedHealthcare uses AI to deny.
  • 🏥 The Human Cost: Why "Deny, Delay, Defend" isn't just about paperwork anymore; it’s about squeezing profits from Medicare Advantage patients who can't fight back.
  • 👮 The Legal Storm: A look at the DOJ investigation and the class-action lawsuits piling up against the healthcare giant.

Tune in to understand exactly how the algorithm works against you. 🎧

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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/

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