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

New England Emergency Response Systems INC

Emergency Response System Companies

Southfield, Michigan

NPI: 1700901725

Risk Tier

Critical

Total Paid

$264.1M

$264,102,390

Total Claims

12.5M

Beneficiaries

804K

Avg Cost/Claim

$21.19

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (5)

Billing Swing

Experienced over 200% change in year-over-year billing with >$1M absolute change.

Billing changed from $15.9M (2018) to $110.1M (2019) — a 593% swing with $94.2M absolute change.

Rate Outlier

Billing above the 90th percentile across multiple procedure codes simultaneously.

Billing above the 90th percentile for 3 procedure codes: A0130 at 2.9× median, 99199 at 10.0× median.

Explosive Growth

Billing increased over 500% year-over-year — far beyond normal growth patterns.

Billing grew 593% from 2018 to 2019.

High Claims Per Patient

Filing an unusually high number of claims per beneficiary compared to peers.

Spending Spike

Experienced a dramatic increase in billing over a short period.

Advanced Detection Signals

Billing Velocity

6743.5 claims per working day — may exceed physically possible volume for a single provider.

Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.

Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024