Suva saves 80 million on erroneous claims
Last year, Suva tracked down 300,000 unjustified claims. To do this, the accident insurer scrutinized more than 2.5 million doctor and hospital bills.
Suva reviewed more than 2.5 million invoices for medical and therapeutic services last year, according to a statement. Of these, the accident insurer corrected or rejected more than 300,000 invoices, saving more than CHF 80 million, according to the company.
"The vast majority of doctors, therapists and hospitals bill correctly," explains Marcel Widmer, team leader for medical costs at Suva. Invoices that are often rejected relate, for example, to duplicate invoices because the doctor has forgotten to charge them or has inadvertently charged them incorrectly.
Spot checks in case of suspicion of systematic misbilling
In the case of invoices received daily, for example, invoices that have already been paid are also checked if systematic errors or incorrect billing procedures are suspected in retrospect. If, for example, a product is dispensed during an inpatient hospital stay but billed as an outpatient, Suva uses random samples of past billings to check whether these are individual cases or whether billing is systematically incorrect. If the suspicion is substantiated, the definitive extent of incorrect billing is determined.
"The fact that Suva takes a close look at invoice control is worthwhile for the insured," explains Michael Widmer. "It means they pay fair premiums, because Suva is not profit-oriented and returns savings to its insured."
Source: Suva
