It has been estimated that fraud costs the private health insurance industry millions of dollars annually. This amount would otherwise be available as benefits to cover the legitimate costs of members.
Simply put, fraud is gaining advantage by deception. It is a crime and any persons found to be involved in such activity may be prosecuted.
TUH is committed to discouraging fraudulent behaviour. We actively monitor claims, regularly conduct member and provider audits to verify that services charged have been received and investigate concerns regarding member or provider behaviour brought to our attention.
You can help us protect the interests of all our members:
Verify benefit statements that you receive from us. Check that all services were received on the dates provided.
Prior to authorising electronic payments via your membership card, check that the services you are being charged for were actually received.
Treat your TUH membership card like your credit card. Don't leave it with your provider.
Allow only persons named on your membership card to use the card.
Notify us promptly if your card has been lost or stolen or if your contact details change.
We have employees that specifically deal with fraud matters. We protect the identity of anyone providing information; you can also remain anonymous. Preventing and detecting fraud saves you and every other member money.
If you suspect health insurance fraud, tell us about it: free call 1300 360 701, or contact the Fraud Officer at fraud.officer@tuh.com.au or PO Box 265, Fortitude Valley, QLD, 4006.
