American Truecare, INC
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2022-01 and has already billed $26.8M, averaging $766K/month across 35 months.
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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $26.8M is at the below 25th percentile among 137 Case Management providers.
Total Paid
$26.8M
$26,813,161
Total Claims
73K
Beneficiaries
60K
1.2 claims/patient
Avg Cost/Claim
$366
🔍 Analysis
Provider Overview
American Truecare, INC is a Case Management provider based in San Diego, CA. From the 2018–2024 period, this provider received $26.8M in Medicaid payments across 73K 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
At $26.8M 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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