Payment integrity overview
Home health & personal care claims
Prebill dollars flagged
$34.2M$34,223,152
366K365,737 claims +4.1%
Prepay dollars flagged
$100.4M$100,390,632
1.03M1,031,004 claims +12.6%
Postpay dollars flagged
$13.9M$13,946,741
73K72,872 claims +2.3%
Dollars flagged per week ($M)
Edits and algorithms beyond medical claims
Use edits, algorithms and models designed to work with non-standard codes.
- Personal Care
- Home Health
- Wound Care
- Other
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Payers have identified $600 million in fraud, waste and abuse for home health and personal care using CareShield AI.