White Glove Community Care, Inc.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 6 procedure codes: S9123 at 5.1× median, T1002 at 11.9× median.
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:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $638.78 per claim for S9123 (Nursing care, in the home, by RN, per 15 minutes) — 5.1× the national median of $124.86.
Bills $442.94 per claim for T1003 (LPN/LVN services, per 15 minutes) — 18.3× the national median of $24.24.
Bills $446.62 per claim for T1002 (RN services, per 15 minutes) — 11.9× the national median of $37.42.
Billing above the 90th percentile for 6 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $540.7M is at the 90th percentile among 137 Case Management providers.
Above 90th percentile for this specialty — higher spending than 123 of 137 peers
Total Paid
$540.7M
$540,711,657
Total Claims
2.6M
Beneficiaries
166K
15.6 claims/patient
Avg Cost/Claim
$209
#107 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
White Glove Community Care, Inc. is a Case Management provider based in Brick, NJ. From the 2018–2024 period, this provider received $540.7M in Medicaid payments across 2.6M 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.
Why This Matters
This provider received $540.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 67,588 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 24 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 71% of total spending.
$383.6M
2.2M claims
$173.02
$82.47
Personal care services, per 15 min
$383.6M
2.2M claims · 70.9%
$69.0M
117K claims
$590.79
$400.25
Nursing care, in the home; per hour
$69.0M
117K claims · 12.8%
$34.9M
55K claims
$638.78
$124.86
Nursing care, in the home, by RN, per 15 minutes
$34.9M
55K claims · 6.5%
LPN/LVN services, per 15 minutes
$33.8M
76K claims · 6.3%
RN services, per 15 minutes
$7.8M
17K claims · 1.4%
$3.9M
16K claims
$246.67
$296.27
Personal care services, per diem
$3.9M
16K claims · 0.7%
Homemaker service, NOS; per 15 min
$2.6M
23K claims · 0.5%
$821K
10K claims
$83.92
$146.45
Adaptive behavior treatment with protocol modification, per 15 minutes
$821K
10K claims · 0.2%
$696K
9K claims
$79.29
$83.88
Skills training & development, per 15 min
$696K
9K claims · 0.1%
$692K
7K claims
$105.53
$161.10
Behavior identification assessment
$692K
7K claims · 0.1%
$585K
16K claims
$35.68
$69.56
Targeted case management, per 15 min
$585K
16K claims · 0.1%
Therapeutic activities, each 15 min
$511K
6K claims · 0.1%
$490K
5K claims
$98.18
$84.12
Therapeutic behavioral services, per 15 min
$490K
5K claims · 0.1%
Speech/hearing/language treatment
$479K
6K claims · 0.1%
$411K
5K claims · 0.1%
$189K
2K claims
$104.90
$82.72
Psychoeducational service, per 15 minutes
$189K
2K claims · 0.0%
Therapeutic exercises, each 15 min
$145K
2K claims · 0.0%
$61K
762 claims · 0.0%
$36K
459 claims
$78.29
$20.04
Therapeutic procedure, neuromuscular reeducation, per 15 minutes
$36K
459 claims · 0.0%
$25K
106 claims · 0.0%
Gait training
$24K
304 claims · 0.0%
$9K
45 claims
$205.46
$5.39
Unlisted special service, procedure, or report
$9K
45 claims · 0.0%
$3K
63 claims · 0.0%
$2K
28 claims · 0.0%
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