It is well known that many healthcare providers remain beneath the radar of individual medical schemes, but once you begin to pool the claims data of your medical scheme with that of others, the combined view of claimed activities within the practice present a completely different view.
Stop-It Satellite is a neutral entity, not affiliated to any medical scheme administrator, medical scheme, industry body or investigative firm and therefore perfectly positioned to embark on the much needed industry profiling to identify outliers in the healthcare industry.
This is not a marketing tool, it is purely designed to give the entire industry a satellite view of the fraud problem.
This is how we can be of assistance:
With the Stop-It Satellite tool we will collect as many Medical Schemes’ claims data and collate it into a neutral industry wide database
Once the data is collated, it will be analysed and reports will be generated. These reports will be provided to each participating medical scheme, providing the players in the healthcare industry with a better edge in combating fraud.
What we track
We will identify outliers per discipline. By combining all the data into one set, it will be possible to see the entire industry’s claims for each practice and illustrate with some basic metrics how some healthcare providers manage to evade detection of irregular claiming habits by keeping their claims per medical scheme within “normal” range. We believe this methodology will impact hugely on the known repeat offenders.
Interactive Website Stop-it.co.za
- Monthly News letter
- Relevant Publications
- Fraud Reporting Facility
- Hall of Fame & Hall of Shame
- Links to Social Media Fraud Awareness pages
- Competition & Surveys
Bulk Sms’s to all policy holders
- Fraud Tips
- Fraud Quotes
- Competition & Surveys
- Healthcare trustee training
- Healthcare investigator training
- Workshops & Seminars
- Fraud Awareness at Wellness days
- Fraud Resilience Surveys
- Integrity Surveys
Fraud Strategies and Fraud Policies
- Draft new Strategies / Policies
- Update existing Strategies / Policies
- Implementation Workshops
- Streamline Internal Controls
Hospital Cashplan Forum
- Centralized Database
- Data Analysis
- Everyone benefits from fraud awareness training because the more people are educated, the more eyes and ears you have to protect your company.
- Creating greater fraud awareness means the more fraud is exposed
- Publishing unethical behaviour is a deterrent to potential criminals
- Fraud awareness training empowers people to take the necessary action to mitigate the risk of it occurring and when it does occur, knowing the correct action to take
- Employee awareness reduces fraudulent benefit claims and cuts contributions costs for all.
- Traditionally fraud is uncovered through expensive data analytics and investigation. Our method invites people to come forward and report what they are experiencing and seeing.
- Our innovative modern media approach allows for videos, pictures and text to be utilized when reporting unethical behavior.