Saudi- Hospital probed for false medical aid claims

(MENAFN- Arab News) The Council of Cooperative Health Insurance (CCHI) has referred a private hospital to the Control and Investigation Board for allegedly forging financial claims for medical procedures.
A man filed the complaint against the hospital claiming that he was charged for medical treatment even though he did not have a file with the facility.
He also claimed that the hospital did not check his identity card.
Mohammad bin Suleiman Al-Hussein general secretary of the CCHI said the body is committed to protecting the industry including companies and beneficiaries a local publication reported.
Al-Hussein said CCHI officials carried out 137 inspections in 2014 covering 23 insurance companies and 114 health providers. Six insurance companies were banned from issuing or renewing health insurance policies because of various violations.
He said five of these companies were allowed to resume operations after complying with corrective measures. Violations in the industry included companies not delivering insurance cards and not providing beneficiaries with their full entitlements.
Other offenses included companies failing to distribute insurance guidance booklets showing benefits and exceptions the scope of coverage and network of service providers.
The CCHI is also reportedly considering instituting control measures that would result in a quality health insurance industry that protects the rights of all parties especially the insured.
Sources said the CCHI received 585 complaints from beneficiaries a 56 percent increase compared to 2013. A total of 96.28 percent of these complaints have been solved with 3.53 percent referred to other bodies.
Sources said 1329 complaints were registered against insurance companies and 186 against business owners.