Healthcare Fraud in South Africa

Healthcare Fraud in South Africa

News and Commentary

Here’s a good article about fraud control in South Africa.

One of the things they talk about is calling patients when a doctor billed more services in a day than he could possibly perform. A key to making that work well is being able to identify outliers immediately and call patients before they forget the service or move. Often analysis like this is not done for a least a month after the claim was paid, which can be long after the service was provided. Having a report within 24 hours of processing the claims (and before the checks are mailed out) can save lots of money and stop fraud before it really gets started.