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

Nebraska 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

47 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$2.3B

Total Claims

46.2M

Unique Providers

3.3K

Watchlist

312

47 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$213.1M3.2M
99214Office o/p est mod 30 min$150.4M2.0M
T1015Clinic service$101.4M451.6K
99284Emergency dept visit mod mdm$86.7M763.6K
90834Psytx w pt 45 minutes$86.5M868.3K
99283Emergency dept visit low mdm$84.4M764.3K
90837Psytx w pt 60 minutes$79.9M583.6K
H2016Comp comm supp svc, per diem$45.9M162.0K
H0018Behavioral health; short-term residential (non-hospital residential treatment$44.2M76.8K
99285Emergency dept visit hi mdm$40.5M344.7K
View all procedures β†’