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Biggest claims paid by health insurer

Southern Cross Health Society has released its latest claims statistics - here's what they pay out on. 

Tuesday, October 30th 2018, 6:33AM

Southern Cross says it has 870,263 members and, as a non-profit organisation has paid out 92c  in claims for every $1 received in premiums.

In the period April 1to September 30 it paid out $567.1 mill in total claims, including:

124,897 surgical procedures
383,223 GP visits
253,361 specialist consults
379,296 prescriptions

Top three specialties by cost:

  1. Orthopaedic – $104.7m
  2. General Surgery – $94.8m
  3. Imaging & Tests – $56.6m

Top three highest claims by cost:

  1. $211,978 – spinal fusion
  2. $170,106 – spinal fusion
  3. $169,723 – spinal fusion

Top three most common surgical procedures claimed for:

  1. Skin lesion excision (including biopsy and freezing) – 31,779
  2. Colonoscopy – 10,718
  3. Nasendoscopy (nose and throat) – 4,698

276,529 members registered to the My Southern Cross app. 

Southern Cross's longest standing membership is 46 years.

Tags: Southern Cross

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