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fraud

May 23, 2022 By SmartLight News Desk

City of Fort Worth prevents $1.7 million in fraudulent pharmacy payments

FORT WORTH, TX – In its work to reduce the cost of employee health care claims, the City of Fort Worth has excluded 24 suspect pharmacies from billing its plan, …

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September 1, 2021 By Franklin Baumann, MD

Eliminating Out-of-Network Benefits Saves Employers Money and Discourages Fraudulent Claims

Eliminating out-of-network (OON) benefits in self-funded employee healthcare plans tackles several  problems for employers and benefits administrators: …

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August 1, 2021 By Franklin Baumann, MD

Telemedicine leaves space open for FWA

The continued use of telemedicine – made dramatically more mainstream during the pandemic – may open the door for more fraud, waste, and abuse in healthcare …

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SmartLight Analytics combines the best inferential analytic models with a team of analytic  and clinical experts to find fraud, waste, and abuse in self-funded employer health care plan claims data.
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