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Hospitals Health Insurance Scam Uncovered

by Medindia Content Team on  March 8, 2006 at 8:57 PM Health Insurance News   - G J E 4
Hospitals Health Insurance Scam Uncovered
The Health Insurance Review Agency (HIRA) found that hospitals had overcharged their patients for health insurance coverage.
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It had received a total of 11,139 complaints last year from patients who doubted their medical fees were right. Following this they analyzed medical institutions' requests for insurance coverage submitted to the agency affiliated with the Ministry of Health and Welfare.

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It was found that in about 29.2 % or 3248 cases the hospitals had overcharged their patients for health insurance coverage. The patients then received about 1.48 billion as medical refunds.

The amount of refunds was up 66 % higher when compared with the previous year. The hospitals included all the insurance-covered treatment as non-insurance-covered and forced the patients to pay more money.

In some cases the patients were charged with extra treatment fees which were already included in their health insurance coverage. The main aim of the agency is to protect patients' rights. It is a free service and is in the system since 2003. Patients can apply for the system via the agency's homepage.

Some civil groups such as the People's Solidarity for Participatory Democracy (PSPD), has also reported that 56 hospitals and clinics are managed illegally and they rake about 700 million in monthly health insurance coverage by forging documents. Some of the hospitals hire brokers for the fabrication of prescription forms and illegitimate requests for health insurance coverage.

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