Fraud in the Independent Sector

August 2008

The question of fraudulent (or erroneous) billing by consultants is something that cannot be condoned. Whilst there may be errors due to coding inaccuracies, all consultants must be aware of their responsibilities in accurately invoicing their patients. Insurers, PPP in particular, have gone out of their way to attack fraudulent or irregularities of billing.

In addition eleven major private medical insurers have created a counter fraud group known as Health Insurance Counter Fraud Group (HICFG) which has formed liaisons with various authorities including the police and the GMC. Whilst directed at fraudulent subscribers or brokers it may also include information about suspect doctors.

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