{"id":3974,"date":"2023-09-28T16:20:25","date_gmt":"2023-09-28T14:20:25","guid":{"rendered":"https:\/\/newmediacreative.co.za\/afrocentric\/?p=3974"},"modified":"2023-10-09T19:44:01","modified_gmt":"2023-10-09T17:44:01","slug":"fight-against-fraud","status":"publish","type":"post","link":"https:\/\/newmediacreative.co.za\/afrocentric\/archives\/3974","title":{"rendered":"Fight against fraud"},"content":{"rendered":"\n<h5 class=\"wp-block-heading\">Fraud is the wilful misrepresentation of facts and\/or any information to illegally obtain financial gain or benefit at the expense of someone else. While there are too many types of fraud to mention here, read on for a brief overview of this scourge.<\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Examples of healthcare fraud include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Non-disclosure of existing or previous medical conditions<\/li>\n\n\n\n<li>Falsified or altered invoices<\/li>\n\n\n\n<li>Member and healthcare provider conspiring to submit false claims and share the refunds paid by the scheme<\/li>\n\n\n\n<li>Members using their membership for individuals who are not dependants<\/li>\n\n\n\n<li>Code manipulation \u2013 a healthcare provider using different billing codes to claim for a more expensive procedure from the scheme<\/li>\n\n\n\n<li>Claiming for original medication but dispensing generic substitutes<\/li>\n\n\n\n<li>Claiming for unnecessary services.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>How can you help?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Check your claim statements carefully to ensure you have received the services that your service provider has claimed for.<\/li>\n\n\n\n<li>Ensure that your membership card and number are safe and secure.<\/li>\n\n\n\n<li>Don\u2019t accept cash from a service provider in exchange for a medical aid claim.<\/li>\n\n\n\n<li>Report suspicious behaviour immediately.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>If you know about fraud, report it. <\/strong>The Fraud Prevention Hotline is always available to help you fight back against fraud, waste and abuse.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Remember that fraud causes all members\u2019 medical aid contributions to increase. If you see it, you can report it anonymously and safely through these channels:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Call 0800112811<\/li>\n\n\n\n<li>SMS 33490<\/li>\n\n\n\n<li>WhatsApp 031&nbsp;308 4664<\/li>\n\n\n\n<li>Email <a href=\"mailto:information@whistleblowing.co.za\">information@whistleblowing.co.za<\/a> or <a href=\"mailto:fraud@medscheme.co.za\">fraud@medscheme.co.za<\/a>.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Together, we can fight for what\u2019s right. Click <a href=\"https:\/\/youtu.be\/2nM3l64UGZo\">here<\/a> to see how fraud, waste, and abuse impact us all.<\/p>\n<div style=\"display:flex; gap:10px;justify-content:center\" class=\"wps-pgfw-pdf-generate-icon__wrapper-frontend\">\n\t\t<a  href=\"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/posts\/3974?action=genpdf&amp;id=3974\" class=\"pgfw-single-pdf-download-button\" ><img src=\"https:\/\/newmediacreative.co.za\/afrocentric\/wp-content\/plugins\/pdf-generator-for-wp\/admin\/src\/images\/PDF_Tray.svg\" title=\"Generate PDF\" style=\"width:auto; height:45px;\"><\/a>\n\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Fraud is the wilful misrepresentation of facts and\/or any information to illegally obtain financial gain or benefit at the expense of someone else. While there are too many types of fraud to mention here, read on for a brief overview of this scourge. Examples of healthcare fraud include: How can you help? If you know [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":4058,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[221],"tags":[214],"class_list":["post-3974","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-our-knowledge-corner","tag-afrocentric07"],"acf":[],"_links":{"self":[{"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/posts\/3974","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/comments?post=3974"}],"version-history":[{"count":4,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/posts\/3974\/revisions"}],"predecessor-version":[{"id":4248,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/posts\/3974\/revisions\/4248"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/media\/4058"}],"wp:attachment":[{"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/media?parent=3974"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/categories?post=3974"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newmediacreative.co.za\/afrocentric\/wp-json\/wp\/v2\/tags?post=3974"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}