June 2019 During monthly monitoring of a client's claims, the SmartLight Analytics’ team identified potential abusive billing by a licensed …
[Read more...] about CASE STUDY: Uncovering potential abusive billing
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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 …
[Read more...] about Phantom billing: Can you spot it in your claims?
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 …
