Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Caringhouse Projects

Respite Care·Atlantic City, NJ·NPI: 1265802847SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

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

ConcentrationHHI: 1 on 2 codes

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Extreme procedure concentration — 95% of all billing flows through just 2 codes (H2016, T2021).

This is a statistical summary, not an accusation. See our methodology.

Compared to Respite Care Peers

Total spending distribution among 8 providers in this specialty

P25MedianP75P90

This provider's total spending of $280.8M is at the 99th percentile among 8 Respite Care providers.

Above 99th percentile for this specialty — higher spending than 7 of 8 peers

Active Billing Period:2018-012024-12(84 months)

Extreme procedure concentration — 95% of $280.8M billed through just 2 codes

Total Paid

$280.8M

$280,807,224

Total Claims

651K

Beneficiaries

24K

27.2 claims/patient

Avg Cost/Claim

$431

#275 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Caringhouse Projects is a Respite Care provider based in Atlantic City, NJ. From the 2018–2024 period, this provider received $280.8M in Medicaid payments across 651K claims.

Why This Matters

This provider received $280.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 35,100 Medicaid beneficiaries for a full year at average per-enrollee costs.

152% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$20.9M
+60%
2019
$33.4M
+6%
2020
$35.4M
+12%
2021
$39.8M
+16%
2022
$46.0M
+14%
2023
$52.6M
+0%
2024
$52.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 2 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 95% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$265.8M

580K claims · 94.7%

Your Cost: $457.99/claim|Median: $321.53
1.4× median
T2021Normal range

Day habilitation, waiver; per 15 min

$15.0M

71K claims · 5.3%

Your Cost: $211.05/claim|Median: $150.51
1.4× median