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

Omni Visions Inc.

Foster Care Agency·Nashville, TN·NPI: 1598043747SharePrint 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:

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.

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

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.

High Cost Per Claim

High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.

Spending Spike

Spending Spike means this provider experienced a dramatic, sudden increase in billing over a short period. Legitimate causes include new contracts or expanded services, but this pattern also appears in billing fraud ramp-ups.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $3,263.51 per claim for H0019 (Behavioral health; residential, per diem) — 9.1× the national median of $357.16.

Bills $1,946.02 per claim for H2020 (Day habilitation, waiver, per 15 minutes) — 13.5× the national median of $144.05.

Bills $698.56 per claim for S5145 (Foster care, therapeutic, child, per diem) — 3.2× the national median of $216.31.

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

Compared to Foster Care Agency Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $133.3M is at the 99th percentile among 10 Foster Care Agency providers.

Above 99th percentile for this specialty — higher spending than 9 of 10 peers

Active Billing Period:2019-082024-10(62 months)

Total Paid

$133.3M

$133,330,444

Total Claims

64K

Beneficiaries

60K

1.1 claims/patient

Avg Cost/Claim

$2K

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

🔍 Analysis

Provider Overview

Omni Visions Inc. is a Foster Care Agency provider based in Nashville, TN. From the 2018–2024 period, this provider received $133.3M in Medicaid payments across 64K claims.

Why This Matters

This provider received $133.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,666 Medicaid beneficiaries for a full year at average per-enrollee costs.

567% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2019
$3.5M
+681%
2020
$27.3M
+2%
2021
$27.7M
-13%
2022
$24.3M
+12%
2023
$27.2M
-14%
2024
$23.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 4 distinct procedure codes. The top code (H0019 (Behavioral health; residential, per diem)) accounts for 52% of total spending.

H0019Top 25%

Behavioral health; residential, per diem

$69.4M

21K claims · 52.1%

Your Cost: $3,263.51/claim|Median: $357.16
9.1× median
H2020Top 5%

Day habilitation, waiver, per 15 minutes

$52.8M

27K claims · 39.6%

Your Cost: $1,946.02/claim|Median: $144.05
13.5× median
S5145Normal range

Foster care, therapeutic, child, per diem

$10.7M

15K claims · 8.0%

Your Cost: $698.56/claim|Median: $216.31
3.2× median
T2033Normal range

Residential care, NOS; per diem

$415K

438 claims · 0.3%

Your Cost: $947.47/claim|Median: $1,051.57
0.9× median

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