In 2016, SmartLight Analytics emerged from a critical observation about the healthcare landscape: employers with self-funded health plans were losing millions to fraud, waste, and abuse hidden within their claims data. Co-founded by Asha George and Dr. Franklin Baumann, the company was born from a desire to help employers take meaningful action against rising healthcare costs. George brought 23 years of experience in healthcare data analysis, while Baumann contributed extensive medical and industry expertise as a former medical director for United Healthcare and CMO of Emdeon. Together, they assembled a team of professionals from healthcare, data science, fraud investigation, and insurance industries to craft innovative solutions for decreasing employer healthcare spending.
SmartLight Analytics provides independent, ongoing monitoring of employee healthcare claims data to find and remove wasteful spend from health plans. By combining the power of AI with clinical expertise, SmartLight identifies situations like low-income participants being taken advantage of by bad actor providers, substance abuse patients falling victim to opportunistic rehab networks, and improper over-treatments throughout the system. The company reviews 100% of medical claims through proprietary inferential analytics customized to each employer's population, followed by expert clinical review. This approach has proven so effective that SmartLight ranked No. 148 on the 2022 Inc. 5000 list and No. 16 among software companies, all while working behind the scenes to save money without requiring employee behavior changes or interrupting benefits.
