Did you know that Canada’s life and health insurers provide supplementary health coverage to 27 million Canadians and pay over $30 billion every year for healthcare services delivered to Canadians through their benefit plans? Healthcare fraud and abuse of benefit plans is increasingly a concern and insurers take this seriously. We continue to make significant investments in technology, skilled staff, and awareness initiatives with our clients to mitigate healthcare fraud.
The industry also recognizes that reducing healthcare fraud and abuse is a team effort. We work closely with healthcare professionals, our clients, and law enforcement to provide education and other tools to minimize the impact of fraud and abuse on benefit plans.
Here are some helpful tips on how you can protect yourself and your benefit plan from fraud and abuse. More tips can be found atclhia.ca/antifraud
• Protect your personal information which includes your benefits plan access information.
• Ensure your receipts are correct and reflect the service or treatment you received.
• Check your explanation of benefits (EOB) provided by your insurers to ensure that it includes only those services or products obtained by you or your eligible dependents.