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

Caring Professional Services INC

Home Health·Hialeah, FL·NPI: 1871546648SharePrint 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:

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.

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

Billing Velocity3197.9 claims/working day

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

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $159.7M is at the 50th percentile among 322 Home Health providers.

Active Billing Period:2018-122024-12(73 months)

Total Paid

$159.7M

$159,685,705

Total Claims

5.1M

Beneficiaries

237K

21.6 claims/patient

Avg Cost/Claim

$31

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

🔍 Analysis

Provider Overview

Caring Professional Services INC is a Home Health provider based in Hialeah, FL. From the 2018–2024 period, this provider received $159.7M in Medicaid payments across 5.1M claims.

Why This Matters

This provider received $159.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,960 Medicaid beneficiaries for a full year at average per-enrollee costs.

2816% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+1473%
2019
$18.7M
+11%
2020
$20.8M
+10%
2021
$22.8M
+15%
2022
$26.1M
+36%
2023
$35.4M
-2%
2024
$34.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 51% of total spending.

T1019Normal range

Personal care services, per 15 min

$81.0M

2.0M claims · 50.7%

Your Cost: $41.23/claim|Median: $82.47
0.5× median
S5130Normal range

Homemaker service, NOS; per 15 min

$34.1M

1.7M claims · 21.3%

Your Cost: $20.27/claim|Median: $48.76
0.4× median
S5135Normal range

Companion care, adult, per diem

$14.6M

636K claims · 9.2%

Your Cost: $23.03/claim|Median: $52.25
0.4× median
T1004Normal range

Services of a qualified nursing aide, per 15 minutes

$12.5M

342K claims · 7.8%

Your Cost: $36.59/claim|Median: $50.30
0.7× median
S5150Normal range

Unskilled respite care, per 15 min

$10.9M

308K claims · 6.8%

Your Cost: $35.41/claim|Median: $84.46
0.4× median
T1021Normal range

Home health aide visit, per 15 min

$3.3M

105K claims · 2.1%

Your Cost: $31.79/claim|Median: $44.79
0.7× median
S9122Normal range

Home health aide or certified nurse, per hour

$2.3M

68K claims · 1.4%

Your Cost: $33.17/claim|Median: $116.67
0.3× median
T1005Normal range

Respite care services, per 15 minutes

$719K

27K claims · 0.5%

Your Cost: $27.08/claim|Median: $71.40
0.4× median
T1030Normal range

Nursing care, in the home, by RN, per diem

$244K

5K claims · 0.2%

Your Cost: $45.85/claim|Median: $85.62
0.5× median
T1003Normal range

LPN/LVN services, per 15 minutes

$5K

305 claims · 0.0%

Your Cost: $15.07/claim|Median: $24.24
0.6× median
T1031Normal range

Nursing care, in the home, by LPN, per diem

$2K

275 claims · 0.0%

Your Cost: $6.73/claim|Median: $80.56
0.1× median
T1001Normal range

Nursing assessment/evaluation, per visit

$1K

27 claims · 0.0%

Your Cost: $42.13/claim|Median: $49.05
0.9× median