Abu Dhabi, September 13: The National Health Insurance Company or Daman has taken action against two dental clinics for overcharging and indulging in malpractices.
Daman Chairman Khaled Abdulla Al Qubaisi said that immediate action was taken against clinics once the cases were discovered.
He added that under no circumstances will any form of abuse or fraud be tolerated by Daman.
“Any provider found committing any form of abuse or fraud will be dealt with immediately through all necessary legal actions,” he pointed out.
Through the frequent medical review of provider invoices and assessments, Daman’s Medical Audit Department found that one provider overcharged Daman for services rendered to its members.
The provider used incorrect codes when invoicing Daman for services that were conducted, said a press release on Saturday. Another provider was found to be invoicing Daman by using false information of its patients and/or service charges.
Some of the alleged cases detected included the provider claiming for services of non-existent patients, while other cases included claims for more services than actually provided.
This was immediately detected by Daman while conducting a regular review of patients’ files against actual invoices. In some instances, the patients concerned were contacted to verify and confirm whether or not these services had been rendered by the provider.
Dr. Michael Bitzer, chief executive officer of Daman, said that Daman’s members and clients play an important role in deterring abuse.
Earlier in the year, Daman introduced a dedicated extension to its existing toll free number 800 4 Daman (32626) for members and clients to report any cases of suspected abuse.
–Agencies