Potential decrease percentage to your healthcare spending
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.
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.”
SmartLight Analytics’ PBM RFP solution helps self-funded employers navigate new PBM selection, contract renewals, market checks or performance evaluations.
As a trusted, independent partner, SmartLight ensures unbiased scrutiny of PBMs, helping employers secure the best terms for their healthcare benefits plan and members. SmartLight Analytics brings deep expertise in PBM industry practices, pricing evaluation, conflict-of-interest reviews and pharmacy data analytics.
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.
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.
Contact our team today to schedule a consultation and discover how SmartLight Analytics can help you navigate the PBM RFP process with confidence and transparency.
