Patriot Home Care INC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $6.2M (2020) to $31.9M (2021) — a 416% swing with $25.7M absolute change.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code W1793 (1 unique codes).
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:
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.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
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
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Extreme procedure concentration — 100% of all billing flows through a single code (W1793).
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $135.8M is at the 25th percentile among 322 Home Health providers.
Extreme procedure concentration — 100% of $135.8M billed through a single code
Total Paid
$135.8M
$135,805,884
Total Claims
824K
Beneficiaries
31K
26.4 claims/patient
Avg Cost/Claim
$165
#834 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Patriot Home Care INC is a Home Health provider based in Philadelphia, PA. From the 2018–2024 period, this provider received $135.8M in Medicaid payments across 824K claims.
Why This Matters
This provider received $135.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,975 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 1 distinct procedure code. The top code (W1793 (State-defined waiver service)) accounts for 100% of total spending.
$135.8M
824K claims
$164.90
$170.32
State-defined waiver service
$135.8M
824K claims · 100.0%
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