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

Department of Disability and Aging Tennessee Early Intervention System (teis)

Case Management·Nashville, TN·NPI: 1437526597SharePrint 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:

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

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 1 codes

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

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $117.9M is at the 50th percentile among 137 Case Management providers.

Total Paid

$117.9M

$117,865,639

Total Claims

201K

Beneficiaries

201K

1.0 claims/patient

Avg Cost/Claim

$586

🔍 Analysis

Provider Overview

Department of Disability and Aging Tennessee Early Intervention System (teis) is a Case Management provider based in Nashville, TN. From the 2018–2024 period, this provider received $117.9M in Medicaid payments across 201K claims.

Important Context

  • ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.
  • ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.

Why This Matters

This provider received $117.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 14,733 Medicaid beneficiaries for a full year at average per-enrollee costs.