Hope House Foundation
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $3,804.49 per claim for H2014 (Skills training & development, per 15 min), which is 45.4× the national median of $83.88.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code H2014 (2 unique codes).
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Compared to Day Training Developmentally Disabled Services Peers
Total spending distribution among 22 providers in this specialty
This provider's total spending of $77.9M is at the below 25th percentile among 22 Day Training Developmentally Disabled Services providers.
Total Paid
$77.9M
$77,863,933
Total Claims
21K
Beneficiaries
10K
2.2 claims/patient
Avg Cost/Claim
$4K
🔍 Analysis
Provider Overview
Hope House Foundation is a Day Training Developmentally Disabled Services provider based in Norfolk, VA. From the 2018–2024 period, this provider received $77.9M in Medicaid payments across 21K claims.
Why This Matters
At $77.9M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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