Pickens County Board of Disabilities and Special Needs
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2022-04 and has already billed $20.2M, averaging $613K/month across 33 months.
Instant Volume
New provider billing over $1M in their first year of Medicaid participation.
Billed $5.5M in first year (2022).
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0812 (near-zero variation).
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:
New Entrant
New Entrant means this provider began billing Medicaid recently but is already receiving millions of dollars in payments. While some new providers legitimately grow fast (e.g., large group practices), this pattern is also common in fraud schemes that set up shell companies to bill aggressively before shutting down.
Instant Volume
Instant Volume means this provider billed over $1 million in their very first year of Medicaid participation. New providers typically ramp up gradually, so immediate high-volume billing can be a red flag.
Consistent Billing
Consistent Billing means this provider's monthly billing amounts show almost no natural variation. Real medical practices tend to have some fluctuation in monthly billing, so unnaturally steady billing can indicate automated or fabricated claims.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Day Training, Developmentally Disabled Services Peers
Total spending distribution among 56 providers in this specialty
This provider's total spending of $20.2M is at the 25th percentile among 56 Day Training, Developmentally Disabled Services providers.
Total Paid
$20.2M
$20,222,206
Total Claims
120K
Beneficiaries
5,609
21.3 claims/patient
Avg Cost/Claim
$169
🔍 Analysis
Provider Overview
Pickens County Board of Disabilities and Special Needs is a Day Training, Developmentally Disabled Services provider based in Easley, SC. From the 2018–2024 period, this provider received $20.2M in Medicaid payments across 120K claims.
Important Context
- 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
At $20.2M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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