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

Arkansas 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

129 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$8.5B

Cumulative, Jan 2018 – Dec 2024 (7 years)

β‰ˆ $1.2B / year

Total Claims

170.1M

Cumulative, Jan 2018 – Dec 2024 (7 years)

β‰ˆ 24.3M / year

Unique Providers

6.9K

Distinct billing NPIs, Jan 2018 – Dec 2024

Watchlist

500

129 highest/critical risk

Current (as of latest ETL)

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
T1015Clinic service$1.4B19.7M
H2016Comp comm supp svc, per diem$661.7M2.8M
92507Tx sp lang voice comm indiv$454.4M7.0M
97530Therapeutic activities$414.1M7.0M
T1019Personal care ser per 15 min$352.2M5.5M
90837Psytx w pt 60 minutes$299.9M3.6M
97110Therapeutic exercises$261.2M4.6M
99214Office o/p est mod 30 min$198.2M4.4M
H2019Ther behav svc, per 15 min$189.4M2.4M
H0019Behavioral health; long-term residential (non-medical, non-acute care in a$187.5M719.9K
View all procedures β†’