Probe clears Mediclinic of billing fraud
The ENSafrica investigation included interviews with hospital staff and a review of more than 120,000 emails and documents
Extensive investigations by law firm ENSafrica and medical scheme administrator Discovery Health have cleared private hospital group Mediclinic of billing fraud at its Southern Africa subsidiary. Mediclinic is owned by JSE-listed Remgro, and owns hospitals in Southern Africa, Switzerland and Middle East.
Mediclinic appointed law firm ENSafrica in August 2023 to conduct a forensic investigation into anonymous claims of billing irregularities at six hospitals in Gauteng and Western Cape. The whistle-blower claimed the ICD-10 codes on patients’ bills were manipulated to inflate the claims submitted to medical schemes...
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