Everyone will agree that emergency care is a necessary and important part of the US healthcare system. Timely access to emergency care is undisputed. The role of the ER is undermined, however, when used for non-emergent care that can be safely rendered elsewhere. A recent report by Accenture examined one
How the City of Fort Worth Saved Millions In the United States, prescription drug spending in 2020 reached $358.7 billion; $3.5 billion is estimated to be fraud, waste, and abuse. The City of Fort Worth, Texas — the 12th largest city in the U.S. and the 5th largest in the
Businesses across the board, from automakers to tech companies to taxpayer-funded school systems, spend a large portion of their budgets on employees in the form of salary and benefits. A rapidly growing percentage of these costs go to fund employee healthcare benefits. The expense is significant for both employers and
PLANO, TX – SmartLight Analytics opens its new Plano, Texas, headquarters this week beginning a new chapter for the growing team of data and clinical experts working to help self-funded employers to reduce healthcare spending by identifying and eliminating fraud, waste, and abuse in healthcare claims. The new office
Eliminating out-of-network (OON) benefits in self-funded employee healthcare plans tackles several problems for employers and benefits administrators: healthcare plan costs, dealing with laborious ERISA out-of-network appeals and the potential for fraud. Employers and their insurance companies negotiate contracts with in-network healthcare providers and facilities such as hospitals and rehabilitation centers.
