Claims Fraud Awareness

Nov 18, 2021Community, Health insurance, Uncategorized

HCi is committed to protecting members from claims fraud

As a not for profit private health insurer, HCi is committed to protecting our members’ interests, while ensuring claims are paid quickly and efficiently. Our objective is to minimise losses from fraud and errors so that we can maximise the amount payable for claims payments to you.

We use an independent, experienced service provider and our own investigative team to review suspected instances of claims fraud, billing errors, and cases of overcharging experienced by our members. Such incidents are thoroughly investigated and rectified with the aim of recovering any erroneous amounts, and deterring any potential fraudulent activity.

This ensures we are not incurring additional costs on your behalf, costs that may ultimately push up the cost of your health insurance premiums.

How can members help protect against claims fraud?

The easiest way for you to help us is to simply be aware of what you are being billed for. Make sure that you:

  • treat your HCi membership card like a credit card – keep it safe – and if you lose it, please report it to us straight away,
  • are aware of what you are being billed for and that you received the treatment recorded, and
  • tell us immediately if you see anything suspicious in your claims history (available via HCi OMS – https://members.hciltd.com.au/)

If you have reason to suspect fraudulent activity, please contact our Membership team on 1800 804 950, providing as much detail as possible. You can choose to remain anonymous if you prefer.