Healthcare Fraud

Staff, patients and drug companies are stealing billions from the healthcare system globally, according to new findings of fraud incidents in healthcare with reports stating that 56 billion Euros are lost to fraud and error in Europe alone.Fraud is being committed at every level.

Some of the most common examples uncovered in included:

• Hospital managers falsely claiming to have done surgical procedures;
• Doctors obtaining a grant to modernise their surgery spending the money on starting a car import/export business;
• Dentists claiming for gold fillings that turn out to be mostly nickel;
• Opticians claiming for sight test fees on patients who have died;
• Pharmacists dividing up prescriptions into smaller packages to boost their fees;
• Patients lying about their entitlement to treatment;
• Drug companies artificially raising the price of key drugs or bribing doctors to prescribe their drug;
• Equipment supply companies installing counterfeit diagnostic equipment.

• With an average of more than five per cent of total revenue lost, it is clear that healthcare organisations need to make a much larger investment in counter fraud work.

Roles we would typically recruit for:

• Insurance claims investigators
• Fraudulent claims handlers and analysts
• Field interviewers/investigators
• Internal auditors
• Information security professionals