We give you the evidence to hold MCOs accountable, grounded in federal coverage rules and multiple years of national Medicaid claims data. $800M to $2B+ in estimated annual fraud exposure. 36 identified vectors. Every one mapped to an IG audit finding.
Operationalize MCO oversight with audit-ready evidence packs and federal coverage rule cross-references.
Direct-to-agency engagementProsecution-grade case files built on federal coverage determinations and MCO denial pattern intelligence.
For MFCUsLitigation-ready evidence for MCO accountability actions, false claims recoveries, and parens patriae work.
For Attorneys GeneralFindings that convert to enforcement, not acknowledgment. Quarterly oversight reporting workflows supported.
For State OIGsMulti-program coverage rule violation modeling and exposure estimates for performance audit work.
For AuditorsQuarterly committee briefings, proviso compliance reporting, and budget variance analysis.
For CommitteesHow Sentinel gets funded, and why it works
Sentinel is typically funded through legislative proviso rather than traditional RFP-based contracting. This means:
The proviso model aligns incentives perfectly:
We can draft your proviso language. Contact David to discuss how to structure legislation that accomplishes your state's program integrity goals across any funded agency.
What data Sentinel needs to deliver results, applicable across any state-funded program
Per-agency pricing based on program size and complexity
Pricing includes 24/7 monitoring, weekly reports, quarterly briefings, and all dashboard access. No setup fees. No per-claim charges. Proviso-funded model available for annual renewal.
What states should expect from Sentinel deployment
15-25%
Verified reduction in improper payments through real-time detection and prevention of fraud before payment. Measured against pre-Sentinel baseline.
10-20%
Prevention of waste through fee schedule corrections, denial management, and claims optimization. Accumulated across all detection vectors.
5x-8x
For every $1 spent on Sentinel oversight, states recover or prevent $5-$8 in fraud, waste, and improper payments.
30 Days
From contract signature to live fraud detection. No lengthy system integrations or lengthy implementations. We're monitoring on day 2.
Sentinel is built for the regulatory environment state agencies operate in
Fast deployment, no disruption to existing systems
Sign contract. Receive secure SFTP credentials and data upload instructions. Your data team uploads claims, eligibility, and provider files via secure file transfer.
Sentinel completes initial analysis on uploaded data. Fraud vectors are calibrated to your state's programs and policies. Kickoff call with agency leadership and David Thorne.
Weekly fraud detection reports. Real-time dashboard access. Monthly calls with agency leadership. Quarterly legislative briefings. Continuous monitoring of new claims and policy changes.
Schedule a 30-minute conversation with David to discuss your state's program integrity goals.
Schedule a 30-Minute Call