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Hospitals & doctors overcharge VHI by €7 million

Health insurer VHI says it clawed back €7 million last year which had been lost to overcharg...
Newstalk
Newstalk

09.13 17 Sep 2013


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Hospitals & doctors overch...

Hospitals & doctors overcharge VHI by €7 million

Newstalk
Newstalk

09.13 17 Sep 2013


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Health insurer VHI says it clawed back €7 million last year which had been lost to overcharging hospitals and doctors. The biggest health insurer here says it is as a result of inquiries led by its Special Claims Investigation Unit (SIU).

The company has not named any hospitals or doctors, nor has it referred any cases to the gardai. The Irish Times says the SIU had recouped a total of €30 million since its establishment in 2006.

The paper also quotes the firm as saying this "forms a critical element in the overall cost containment strategy...This unit is very active and has uncovered a number of cases of what we believe are overcharging".

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"In addition to the SIU, we have a number of robust measures in place to ensure benefit paid on behalf of our customers is appropriate and warranted including pre-verification of claims, data analytics, ongoing audits, third-party recovery, clinical reviews and utilisation management" it added.

It says that each case was "rigorously investigated" and if overcharging occurs, that the providers must pay back the money and introduce corrective measures to stop this from happening again.

Back in June, the insurer saw a loss of €7.2 million.

Its accounts to the end of last December showed a after tax surplus of €54.3 million. But the figures were for the consolidated VHI business and included a one-off credit of €38.2 million relating to curtailed retirement benefits.

The health insurance element of the company was loss-making with a drop of €7.2 million recorded in the year to the end of December 31st last.


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