Discovery Health saves half a billion with fraud detection
Half a billion rand: that is what Discovery Health administrators claim it has saved Discovery Medical Aid — and other medical aids — by uncovering fraud and recovering ill-spent money.However, Discovery Health said there was probably a few more billion rand wasted through fraud each year that is never uncovered. The R568m recovered was up from R405m in 2016‚ the administrators said on Friday.The main offence in 2017 was members and health workers submitting claims for services that had not been offered‚ or pharmacies and members claiming for medicines and medical devices that were never supplied.A Discovery Health statement said: "Pharmacies would supply members of medical schemes with non-claimable items such as baby formula‚ nappies‚ cosmetics and shoes, yet submit claims for prescription medicines. Sometimes pharmacies or doctors dispense generic medicines‚ yet claim for higher cost original medicines."In 2016‚ the administrator uncovered that a particular pharmacy was found to ...
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