SmartLight Analytics has been named a finalist in D CEO Magazine Excellence in Healthcare awards program for Outstanding Service Innovation. “This year’s program attracted nearly 200 nominations across over a dozen categories and added new categories specifically addressing COVID-19. Along with outside judges with knowledge of the healthcare field, the editorial team poured
Can the distance between your medical provider and the lab used to process your test results tell you anything about potential fraud, waste, or abuse? In fact, it can. In reviewing healthcare claims, data specialists use geospatial analysis to compare distances traveled for lab services. This strategy is used in one of many inferential
DALLAS, TX – SmartLight Analytics formed a new partnership with Health Transformation Alliance recently to reduce healthcare spending by identifying and eliminating fraud, waste, and abuse in employer self-funded healthcare claims. HTA, a core group of powerhouse companies, combined forces to negotiate lower healthcare costs. SmartLight brings a new level of depth in analytical, clinical and data expertise to HTA member companies. SmartLight Analytics helps HTA accomplish our
When it comes to healthcare claims analysis, combining both medical and pharmacy claims data provides a more thorough picture of what is happening for specific members (or dependents) and adds an additional analytical layer to help find different types of fraud, waste or abuse that might exist. A case study
What is inferential analytics? This analytic method is used by the SmartLight team to find fraud, waste, and abuse in employee healthcare claims. Simply put, it does not rely only upon algorithms, which are a set of rules created to solve specific problems. Instead, it looks beyond the expected “rules”
