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

Florida 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

1149 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$34.2B

Total Claims

944.8M

Unique Providers

30.4K

Watchlist

3.3K

1149 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
T1019Personal care ser per 15 min$1.9B36.7M
S9124Nursing care, in the home; b$1.5B2.9M
S5130Homaker service nos per 15m$1.4B39.3M
H2017Psysoc rehab svc, per 15 min$1.3B12.5M
H2019Ther behav svc, per 15 min$1.0B15.9M
99213Office o/p est low 20 min$1.0B24.3M
90999Unlisted dialysis procedure$939.6M6.9M
99214Office o/p est mod 30 min$899.2M17.2M
T2030Assist living waiver/month$889.5M796.5K
T1017Targeted case management$851.1M16.0M
View all procedures β†’