Vav Operations LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $581.59 per claim for 97153 (Adaptive behavior treatment by protocol, per 15 min), which is 3.5× the national median of $167.38.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: 97153 at 3.5× median, 96152 at 6.2× median.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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
Bills $581.59 per claim for 97153 (Adaptive behavior treatment by protocol, per 15 min) — 3.5× the national median of $167.38.
Bills $124.12 per claim for 96152 (Health behavior intervention, individual) — 6.2× the national median of $20.02.
Billing above the 90th percentile for 2 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $198.7M is at the 75th percentile among 218 Community/Behavioral Health providers.
Total Paid
$198.7M
$198,705,710
Total Claims
482K
Beneficiaries
48K
10.1 claims/patient
Avg Cost/Claim
$412
#462 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Vav Operations LLC is a Community/Behavioral Health provider based in South Bend, IN. From the 2018–2024 period, this provider received $198.7M in Medicaid payments across 482K claims.
Why This Matters
This provider received $198.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,838 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 16 distinct procedure codes. The top code (97153 (Adaptive behavior treatment by protocol, per 15 min)) accounts for 90% of total spending.
$179.0M
308K claims
$581.59
$167.38
Adaptive behavior treatment by protocol, per 15 min
$179.0M
308K claims · 90.1%
$16.6M
140K claims
$118.89
$146.45
Adaptive behavior treatment with protocol modification, per 15 minutes
$16.6M
140K claims · 8.4%
$1.1M
9K claims
$124.12
$20.02
Health behavior intervention, individual
$1.1M
9K claims · 0.6%
$777K
10K claims · 0.4%
$682K
5K claims
$143.80
$161.10
Behavior identification assessment
$682K
5K claims · 0.3%
Speech/hearing/language treatment
$220K
5K claims · 0.1%
Therapeutic activities, each 15 min
$131K
2K claims · 0.1%
$80K
3K claims
$26.41
$55.95
Group adaptive behavior treatment, per 15 min
$80K
3K claims · 0.0%
Psychiatric diagnostic evaluation
$68K
517 claims · 0.0%
$12K
329 claims
$35.95
$79.21
Psychological testing evaluation by professional, first hour
$12K
329 claims · 0.0%
$5K
145 claims
$34.65
$133.38
Psychological testing evaluation, each additional hour
$5K
145 claims · 0.0%
$4K
140 claims · 0.0%
$4K
158 claims · 0.0%
$1K
89 claims
$15.54
$30.49
Psychological/neuropsychological testing, first 30 min
$1K
89 claims · 0.0%
$1K
88 claims
$14.57
$92.96
Psychological/neuropsychological testing, each additional 30 min
$1K
88 claims · 0.0%
$278
19 claims · 0.0%
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