Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Alaska Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

122 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$6.2B

Total Claims

43.9M

Unique Providers

1.9K

Watchlist

621

122 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
99213Office o/p est low 20 min$507.0M1.9M
T2016Habil res waiver per diem$402.9M1.1M
T2017Habil res waiver 15 min$221.8M887.8K
T2021Day habil waiver per 15 min$210.8M1.4M
99214Office o/p est mod 30 min$203.1M1.2M
T1019Personal care ser per 15 min$180.5M2.4M
A0140Nonemergency transport air$178.3M365.7K
T2031Assist living waiver/diem$146.1M926.6K
99284Emergency dept visit mod mdm$145.8M609.9K
H0047Alcohol/drug abuse svc nos$132.1M285.6K
View all procedures β†’