Private healthcare loses more than R22-billion a year to fraud, waste

estimated to be over R100 million, the government news agency SAnews reported on Monday.

Discovery Health uses a case management system that gives them insights into their members’ claim trends. Based on these trends, Discovery is able to pick up on suspicious activity. Their system has led to R2-billion in direct savings; since 2013, it has helped the scheme to recover more than R5-billion.

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