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Health insurance fraud under the microscope

Thursday, October 2nd 2014, 9:31AM 2 Comments

Private health insurers have agreed to establish an integrity register to tackle fraud and undesirable billing practices in health insurance, believed to cost $29 million in claims every year.

The insurers are members of the Health Funds Association. HFANZ estimates up to 5% of health insurance claims are fraudulent which costs $22 in premiums for every private health insurance member.

The register will be maintained by PriceWaterhouseCoopers, and will enable members to tackle fraud on a more consistent basis and will give the industry a clearer idea of its scale, ensuring a very clear zero-tolerance message is delivered to those who knowingly commit it.

“Health insurers are trying to keep a lid on rising premiums and eliminating fraudulent claims would help this,” HFANZ chief executive Roger Styles says.

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Comments from our readers

On 3 October 2014 at 6:46 pm Tony Walker said:
Is this Fraud committed by policyholders, fraud committed by Medical staff or collusion between clients and medical profession. Can anyone clarify?
On 6 October 2014 at 11:34 am Broker said:
There was a similar article recently in the Herald which seemed to suggest the fraud was coming from the public but maybe it's coming from the specialists ah?..100 fancy overpriced screws used in that surgery instead of 10...

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