We would like to invite you to continue a survey you have started. ...

Do you trust your insurer ?

Strongly agree
Strongly disagree
Insurance provides peace of mind
Insurance is purchased only when compulsory
Terms and Conditions (small print) are clear and easily accessible
Insurance jargon (language) stands in the way of fully understanding each policy
Insurance companies try their best to uphold the details of the policy without cutting corners
Reducing risk, cutting costs and profits are more important to an insurance company than the customer
Insurance companies in the region are as professional as in other more developed markets
Age group
Do you feel your insurance provider works in your interest?
Have you had a rejected claim that you feel was not justified?
Do you trust your insurance provider?
Our Network

Register for our free newsletter

Latest News

Fever pitch

Fever pitch

From over medication to fraud, Green Crescent CEO Carlos J Sardegna talks about the region’s health insurance business heating up.


March 24, 2011 3:05 by

Before we authorise patient care, we preview them for medical necessity and to see it that the procedure is appropriate for the diagnosis. When the patient is in the hospital, we also visit them to ensure that they get all the appropriate care and take a look at what exactly being prescribed, for medical necessity point of view.

It is not an attempt to deny care, but to see to it that no fraud is taking place. And finally, we go back after the case on a random basis.

Q: Where does technology come into play?

There are now software packages available, which can look at the claims and see that the procedures are appropriate for the diagnosis. The frequency of claims per member is somewhere between four and five. So, with 100,000 members, the total number of claims is up to 500,000. We are now looking at the implementation of software packages which will identify anomalies in payment. Whenever we find frauds we pursue it vigorously.  We have provided information to check doctors. We have got payments back from doctors.

Pages: 1 2 3 4


Tags: , , , , , , ,

Leave a Comment