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International Fraud Awareness Week
International Fraud Awareness Week, November 12-18th was initiated by the Association of Certified Fraud Examiners, where hundreds of organisations around the world come together and pledge to spread fraud awareness in their companies and their communities. Many South African Companies and Medical Schemes are actively part of that pledge.
At Aquilla Financial Solutions we are actively involved in educating and encouraging our clients not to commit fraud and create fraud awareness, especially within the medical scheme claims area.
Did you know that healthcare fraud can contribute directly and indirectly to the rise of your medical costs, including your membership contributions? You, as a member or a service provider, have the power to help us prevent fraud for the greater good of all medical scheme members and providers.
What are common examples of medical aid fraud?:
- Falsified or altered invoices.
- Member and healthcare provider conspiring to submit false claims and sharing the money paid by the Scheme.
- Members use their membership for individuals who are not dependents.
- Claiming for original medication but dispensing generic substitutes.
- Claiming for unnecessary services.
You might ask how you can help. There are a number of things that you and I can do:
- Check your claim statements carefully and ensure that you received the services that the service provider is claiming. Be aware that some providers might use your medical scheme details to submit false claims.
- Ensure that your membership card and number are protected at all times. For some criminals, it might be like an ATM card.
- Don’t accept cash from a service provider in exchange for a medical aid claim. The changes are good in that they will put through a highly inflated claim to get back their cash
I want to encourage you to make use of any of the medical schemes' dedicated Whistleblower hotlines reporting channels to report any suspected medical aid fraud.
You are welcome to contact me if you want advice on your decision to change your medical scheme. We can do no-obligation comparisons for you between your different scheme options or between different medical schemes.
Remember that you have to make your option changes before the medical scheme due date.
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Protecting your Digital Assets
For a very long time, I have been wondering about the increasing use of digital media in our lives. Almost anything that we can think of has some form of digital interaction.
Just think for a moment what you are currently busy doing on your phone. Many people are doing almost all electronic interactions on their cell phones. Maybe it is easier to ask what they are not doing on their cell phones. I am a bit more conservative in this regard since I do not want my hundreds of work email messages coming to my phone. I want to choose when I want to or can answer these emails.
The demand to answer all questions instantly at any time of night and day brings with it an enormous amount of stress to the individuals not even touching on the possible addictions that might be experienced if not managed well.
Let us talk a bit about what is considered digital assets.
Computer Weekly have created a base definition for what a digital asset might be. What do you consider digital assets in your environment?
Computer Weekly proposed the following definition for digital assets: Digital Assets = Data (which is in files) + Content (which is in the form of metadata). Another definition from The Balance is: “Digital assets are items you can buy, sell, and hold online, but typically can’t physically see or touch” and “Digital assets are anything that can be stored and transmitted electronically through a computer or other digital device and are associated with ownership or use rights”. This is quite a wide definition but so are the numerous variations of types of digital assets.
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- International Fraud Awareness Week
- Protecting your Digital Assets
- Important Changes to Non-profit Organisations (NPO) Act
- 2023 Medical scheme changes and increases
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