Three seemingly unrelated imaging providers based in FL were identified in a self-funded employer’s medical claims for what was later verified as phantom billing. The utilization patterns seen in paid claims history for an employee and his wife indicated a strong probability of “phantom” billing – billing for services never
Multiple healthcare fraud schemes have been investigated over the years involving providers who misrepresent cosmetic procedures as medically necessary ones to increase patients and their profit. Rhinoplasty is known to be the most common procedure that is inappropriately billed to health insurance. Surgeons charge for repair of a “deviated septum”
FORT WORTH, TX – The Dallas-based health care analytics firm, SmartLight Analytics, will soon begin an initial assessment of the City of Fort Worth’s employee health care claims data in an effort to further reduce the city’s health care spending costs, which in 2017 went $15.2 million over budget. “The
July 8, 2019 FORT WORTH, TX – As executives across the country are looking for ways to reverse the trend of ever-increasingemployee healthcare costs and the government is pushing for more transparency in billing, a Dallas-based analytics firm is providing a new way to accomplish both. Asha George, CEO and