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

New Hampshire 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

57 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$6.0B

Total Claims

60.5M

Unique Providers

2.1K

Watchlist

181

57 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
T1020Personal care ser per diem$1.3B4.0M
T2021Day habil waiver per 15 min$493.9M2.9M
T1016Case management$413.2M2.5M
T2025Waiver service, nos$373.9M327.3K
T1019Personal care ser per 15 min$280.9M2.0M
H0019Behavioral health; long-term residential (non-medical, non-acute care in a$229.8M164.5K
S5140Adult foster care per diem$177.8M378.5K
T1015Clinic service$159.4M936.0K
H2019Ther behav svc, per 15 min$145.8M1.6M
E0766Electrical stimulation device used for cancer treatment, includes all$112.8M14.7K
View all procedures β†’