Data Services

Workers collaborate on a project
3 %

Potential decrease percentage to your healthcare spending

On-going monitoring of your healthcare data

SmartLight Analytics combats waste, abuse and low-value care in healthcare claims by combining the power of AI with clinical expertise. Requiring the bare minimum in employer involvement, our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes. 

What does on-going monitoring find?

Monitoring of 100% of claims finds low-value and medically unnecessary claims as well as services not rendered, pricing errors, non-covered services, duplicate billing, payment errors, billing errors and fraudulent or abusive claims.

“I have a fiduciary insurance policy, it's called SmartLight Analytics!”

“I highly recommend SmartLight to any health insurance carrier looking to enhance their processes and optimize their workload. SmartLights’ commitment to excellence and unwavering support make them an invaluable partner in achieving our goals.”

GET MORE VALUE WITH

ADDITIONAL TOOLS

Flatten or reverse increasing healthcare spend by redirecting dollars toward the most value-added programs

Teams working together

Fiduciary Value Analysis (FVA)

The FVA educational tool helps employers ensure their programs are beneficial, that plan dollars are being used for the sole and exclusive benefit of the plan members, that fees being charged are reasonable, and offers opportunities to refine ASA agreements for optimum value.
• Insight into the value of programs associated with your healthcare plans.
• Reconciliation to verify payments against component line items, ensuring no discrepancies.
• Compares buy-up program fees to the claims data, to understand the value of various healthcare cost reduction services and add-on features.

SmartLight Health Data Warehouse (SHDW)

We serve as your data pipeline, acting as a steward of your data. Store and present claims administration data in a clear and useful way using our data warehouse.
Through the SHDW platform, SmartLight helps employers understand the relationships between members, providers, claims administration, and health plans by reporting data for employers and offering insight.