Providers

SHARON D WALTZ, Psy.D.

NPI 1295025997, individual, Pelham, AL, Psychologist, Clinical

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 5 months, but with up to 857 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 9070, $767K at stake

Public list actions

OIG exclusion June 20, 2022 under section 1128a1
Ind- Lic HC Serv Pro, Psychology, Greenville, IL

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jan 2018More hours than a day holds, even counting one unit per claim line50.959.139.453.1683190791 90832 90837 90846 90847 96116$138K
Feb 2018More hours than a day holds, even counting one unit per claim line64.975.450.370.4757190791 90837 90847 96116$159K
Mar 2018More hours than a day holds, even counting one unit per claim line59.979.753.274.9857190791 90837 90847 96116$193K
Apr 2018More hours than a day holds, even counting one unit per claim line58.681.754.577.8845190791 90837 90847 96116$195K
May 2018More hours than a day holds, even counting one unit per claim line24.233.722.530.3490190791 90837 90847 96116$82K
Jun 2018More hours than a day holds, even counting one unit per claim line29.726.517.725.2433190791 90837 90847 96116$69K
Jul 2018More hours than a day holds, even counting one unit per claim line26.922.715.121.3480190791 90832 90837 90847 96116$61K
Aug 2018More hours than a day holds, even counting one unit per claim line25.120.613.718.5491190791 90832 90837 90846 90847$55K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameSHARON D WALTZ, Psy.D.
TypeIndividual, sole proprietor
StatusActive
NPI issuedApril 14, 2011, last updated September 29, 2011
Practice location1365 CALISTON WAY, Pelham, AL 35124, 330-966-0922
Specialties
Psychologist, Clinical (103TC0700X, primary, license 1228 AL)
Psychologist (103T00000X)
Clinical Neuropsychologist (103G00000X, license AL-1228 AL)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
96116Exam of neurobehavioral status, first hour$585K38%$255$59 (top 5% from $351)92nd percentile
90837Psychotherapy, 1 hourhistory of abuse$372K24%$161$191 (top 5% from $442)36th percentile
90847Family psychotherapy with patient, 50 minutes$366K24%$161$130 (top 5% from $458)65th percentile
96101Medicaid service code$137K9%$248$219 (top 5% from $671)57th percentile
90791Psychiatric diagnostic evaluation$55K4%$100$105 (top 5% from $228)46th percentile
90832Psychotherapy, 30 minutes$4K0%$41$59 (top 5% from $239)too few months to rank
90846Family psychotherapy without patient, 50 minutes$2K0%$50$113 (top 5% from $277)too few months to rank
90834Psychotherapy, 45 minutes$4660%$39$101 (top 5% from $318)too few months to rank

In this area

2 providers in Shelby County, AL carry an indicator in the public record, with $7.3M at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.

tierproviderat stakewhy
3MID-SOUTH HOME HEALTH, LLC
Hoover, AL, ranked 3326
$0
  • Part of provider network D1-00090, ranked 90 nationally.
4ANDREW ROZSA
Birmingham, AL, ranked 8332
$7.3M
  • Hours beyond a day in 82 months, but with up to 983 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.

Recent enforcement in AL

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

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