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December 3, 2020 By SmartLight News Desk

SmartLight Analytics named “Outstanding Service Innovation” winner in the D CEO 2020 Excellence in Healthcare awards

SmartLight Analytics is honored to be recognized by D CEO as a 2020 Excellence in Healthcare Award winner for our work to reduce healthcare costs for self-funded employers. The work to identify and eliminate fraud, waste and abuse in healthcare claims this year has become especially important as employers continue to provide coverage for employees during the pandemic.

For the team at SmartLight Analytics, however, the opportunity to make an impact in making healthcare more affordable is our true reward. We also want to thank Health Transformation Alliance, who nominated SmartLight for this award. Our partnership with HTA has broadened our ability to help self-funded employers across the country to eliminate wasteful and fraudulent spending in their healthcare plans. Moving into 2021, we are ready to partner with more companies to reduce healthcare costs without disruption to the quality of care and coverage for their employees. Making healthcare more affordable is our continued mission.

D CEO 2020 Excellence in Healthcare winners

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Filed Under: Analytics, costs, fraud, healthcare

Eliminating Out-of-Network Benefits Saves Employers Money and Discourages Fraudulent Claims

September 1, 2021 By Franklin Baumann, MD

liminating out-of-network (OON) benefits in self-funded employee healthcare plans tackles several  problems for employers and benefits administrators: healthcare plan costs, dealing with laborious ERISA out-of-network appeals and the potential for fraud.

Telemedicine leaves space open for FWA

August 1, 2021 By Franklin Baumann, MD

The continued use of telemedicine – made dramatically more mainstream during the pandemic – may open the door for more fraud, waste, and abuse in healthcare claims.

Identifying Provider Fraud in employee healthcare claims

July 14, 2021 By SmartLight News Desk

Analysis of healthcare claims from a sampling across multiple employers with self-funded healthcare plans and a combined total of more than 100,000 members, identified over $25 million in fraud, waste, and abuse by providers.

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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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