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Reducing healthcare costs for self-funded employers

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News & Blog

Phantom billing: Can you spot it in your claims?

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
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Cosmetic Surgery Is Ripe for Fraud

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”
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City of Fort Worth engages SmartLight to reduce health care spend

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
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Analytics firm tackles rising cost of healthcare

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
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Recent Posts

  • City of Fort Worth prevents $1.7 million in fraudulent pharmacy payments
  • Data Solution to Tackle Fraud, Waste, and Abuse
  • No Surprises Act Mostly a Positive Change for Self-Funded Employer Health Plans
  • Will ERISA Reforms Lead to Health Reforms?
  • Do All Physicians Have a Medical Degree?

See all SmartLight Blog posts.

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  • White Paper

SmartLight White Papers

The expanding cost and responsibilities associated with employer-sponsored healthcare

As the rising costs of healthcare benefits and the rising percentage of employee contributions converge, companies across America are faced with a new scenario that finds them looking for ways to reduce healthcare spending and protect their employees’ contributions. How should a business whose mission is to build cars or develop software deal with this increasingly complicated situation?

Download SmartLight’s Whitepaper:

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SmartLight Analytics combines the best inferential analytic models with a team of analytic  and clinical experts to find fraud, waste, and abuse in self-funded employer health care plan claims data.
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SmartLight Analytics has been named finalists in D CEO Magazine Excellence in Healthcare Awards 2020 for Outstanding Service Innovation.

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