Data Insights

More in-depth insights from SmartLight Analytics


A Data Solution for FWA

Fraud, Waste & Abuse in Healthcare Claims

As a self-funded employer, you play a vital role in protecting the integrity of your health care program. In this document you will learn about: 

  • The problem of FWA facing employers
  • Differentiating between fraud, waste, and abuse.
  • Federal laws governing health care regulations.
  • What FWA costs your health plan.
  • How to protect your dollars.

Who's Watching the Money?

Examining exactly where health care dollars are spent is not just a budget management or cost-saving practice for business, as plan sponsors are reminded often, it is also a fiduciary responsibility under the Employee Retirement Income Security Act (ERISA). 

A Data Solution to Tackle Fraud, Waste and Abuse

The City of Fort Worth, Texas — the 12th largest city in the U.S. and the 5th largest in the state — presents a textbook case study for the pervasiveness of pharmacy fraud hidden in health care claims and the action required to combat the ever-evolving abuse.

The hidden cost driving up mental healthcare

The hidden cost driving up mental healthcare

An old scheme previously identified in Long Term Care (LTC) facilities has become routine in residential mental health settings as well. An increasing number of suspect mental health facilities are viewing its residents as revenue streams at the expense of the employers’ health plans and driving up costs.

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