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What would be a medical fraud using the advanced technology ?

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Question added by Santhosh HK , Process Leader , AXA Business Services Pvt Ltd
Date Posted: 2014/02/23
Bibhu Mishra
by Bibhu Mishra , Operations , Aurobindo Pharma Ltd

Technology can be used in many case senarios to execute a Medical Fraud like

1.Frauds in Claims Submitted to insurance companies like -

Claims for visits that never took place.

Fabricated claims for nonexistent medical facilities.

Claims submitted for Medical Equipments which were not used..

Claims submitted with higher cost than the actual agreed cost of procedure.

2. Frauds in Technologies of the HIS

Patients details can be hacked, misused

Details of procedures to be perfomed, can be altered, hacked..

Interchange of procedures of the patiets can lead to serious problems.

 

 

 

SUMESH KARUVELIL SUDHAKARAN
by SUMESH KARUVELIL SUDHAKARAN , ASST.MANAGER , MSD PHARMACEUTICALS PVT.LTD

Fraud happens in any type of advanced technology.It can happen like we can post the stocks and keep pending for invoicing which stock position shows excess while doing physical checking these excess stocks can misuse. to avoid this every month stock in quantity vs stocks out quantity we have to match.

ramesh dayala
by ramesh dayala , pharmacist , health care pharmacy

fraud happens every where but through advanced technology it can be revealed. the improper billing which the fraud committed can be stored in a system for a long time when the inspection will be done by the drug inspector he have to show all previous records which are saved through advanced software. fraud happens in billing when they done manual pricing by adjusting MRP..

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