NEMT spend is rising, oversight infrastructure isn’t, and the highest-risk segment — fee-for-service — is also the least visible. Without trip-level verification, agencies and payers are left reconciling after the money is gone, defending payment decisions they can’t fully document, and absorbing improper payments that erode both budgets and federal confidence.
CMS has made it clear: program integrity in NEMT is no longer optional. Improper payments, ghost rides, upcoding, and broker self-dealing are under active federal scrutiny. The question is whether you find these patterns first — or your auditor does.
Generic fraud analytics weren’t built for transportation.
Sentinel targets the specific schemes that drain NEMT programs:
Ghost rides
Trips billed but never delivered, caught through GPS and electronic-visit-verification against completed-trip data.
Inflated mileage & upcoding
Claims that overstate distance or level of service, validated against actual routes and trip records.
Duplicate & double billing
The same trip submitted twice, or split to inflate payment, flagged before adjudication.
Phantom attendants & unnecessary service levels
Non-medical attendant charges and higher-acuity codes that don’t match the trip, surfaced through level-of-service validation.
Provider-broker collusion & out-of-network routing
Kickback patterns where members are steered to higher-cost or affiliated providers, exposed through network and referral analysis.
Beneficiary identity fraud
Kickback patterns where members are steered to higher-cost or affiliated providers, exposed through network and referral analysis.
Impossible-day analysis
Overlapping trips, physically impossible schedules, and provider-level outliers identified through temporal and geospatial logic.
Step 1
Sentinel validates trips against dispatch, GPS, and EVV data — so improper and inflated claims are flagged before they reach your payment systems, not painfully recovered afterward.
Step 2
A single oversight layer across brokers, transportation providers, and managed care subcontractors. Configurable dashboards align with your KPIs and provide on-demand visibility into network behavior, cost drivers, and risk concentration.
Step 3
Every flagged claim comes with verifiable, timestamped evidence — ready for internal review, MFCU referral, or a CMS audit. Defensible decisions, documented by default.
Step 4
Sentinel is a tech-enabled service. You get detection infrastructure and the team behind it without having to stand up an investigations unit or rebuild your MMIS.
Sentinel is designed around what program leadership actually has to answer for:
Demonstrate active oversight of federal matching funds with the documentation CMS and OIG reviewers expect — and position your program ahead of federal NEMT scrutiny rather than reacting to it.
Stop improper payments pre-adjudication (avoidance) and build referral-ready packages for post-payment recovery — turning oversight from a cost center into a return.
Every action is backed by verifiable trip data. No judgment calls you can’t document.
Sentinel integrates with your existing claims, eligibility, and EVV systems. You gain oversight without adding operational burden to your team.
See where your NEMT dollars are leaking before you commit to anything bigger. A focused Sentinel pilot quantifies your exposure, validates detection against your own data, and gives you a clear path to full program oversight.