2023-08-02 00:08:47
In today’s fast paced world, complex matters such as health insurance can be difficult to understand. But there is power in knowledge and understanding. In this article, we will discuss the recent warning from the Saudi Health Insurance Council about the possibility of falling into forms of health insurance fraud and misuse.
Health insurance is one of the most important things a person needs in his life. But, sometimes, people take advantage of this great trust and violate the rights of others, which leads to widespread health insurance fraud and misuse.
In a publication, the Council revealed the most prominent types of fraud and misuse of health insurance. These types include, but are not limited to: impersonating a beneficiary, non-disclosure of work injuries, and repeat medical visits without a health reason.
Manifestations of fraud and its avoidance
Manifestations of fraud are cooperation with doctors or pharmacists to obtain services that are not covered, the beneficiary concealing the true state of his health before insurance, and submitting false replacement requests.
The Council indicated that the forms of misuse of health insurance are the exploitation of the service of providing medicines and treatment in irregular ways, and the beneficiary obtaining treatment services for non-covered benefits and presenting them as covered ones, and repeating chronic disease analyzes in short periods without need.
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