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

Louisiana 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

157 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$19.4B

Total Claims

421.6M

Unique Providers

11.6K

Watchlist

1.2K

157 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
S5125Attendant care service /15m$3.6B25.3M
T1015Clinic service$1.5B13.8M
T1019Personal care ser per 15 min$1.2B18.2M
99214Office o/p est mod 30 min$721.0M17.1M
99284Emergency dept visit mod mdm$699.5M6.3M
99213Office o/p est low 20 min$664.5M26.1M
H2036A/d tx program, per diem$643.6M4.4M
H0036Comm psy face-face per 15min$483.0M6.3M
99285Emergency dept visit hi mdm$477.1M3.8M
99283Emergency dept visit low mdm$470.7M5.4M
View all procedures β†’