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BHF FMU Strategy for 2007

BHF FMU Strategy for 2007. Dedicated healthcare fraud prosecutors through the NPA/SCCU PPP knowledge of medical aid environment FMU administrator to assist industry investigators with document preparation process on dealing with recoveries support from HPCSA and SAMA Joint analysis

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BHF FMU Strategy for 2007

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  1. BHF FMU Strategy for 2007

  2. Dedicated healthcare fraud prosecutors through the NPA/SCCU • PPP • knowledge of medical aid environment • FMU administrator to assist industry investigators with document preparation • process on dealing with recoveries • support from HPCSA and SAMA • Joint analysis • claims and consultation profiling • BHF data warehouse • non-competitive information • holistic view of claiming patterns • encourage peer review • benchmarking • joint investigation

  3. Registry of expertise – handwriting • coding • investigating, e.g. body language • Membership database – dual membership - processes (claims/handwriting) • Broker fraud listing • Establish links with Professional Councils in other countries

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