GetSavvi Health Logo

How healthcare fraud affects your pocket

Product info • by Ryno Ellis • 01 August 2017
Healthcare fraud and abuse in South Africa is rife, and unfortunately, it negatively affects both the companies providing healthcare services and the pockets of their members.

According to a recent report at least 10% to 15% of all claims made to healthcare providers are fraudulent. This adds up to billions of rands which has a profound negative impact on both members and the schemes they’re signed up with.

Here are a few examples of healthcare fraud and abuse:

Healthcare abuse

Healthcare fraud

How fraud and abuse affects you, the member:

Tauhir Manuel, Chief Executive Officer at GetSavvi Health, explains that healthcare fraud is a very complex form of financial fraud. He says that it can involve and be committed by a combination of members, healthcare professionals, healthcare service providers and brokers.

Manuel says that these types of abuse and fraud generally have two impacts.

“For healthcare schemes it increases costs, not only from a claims paid, but also from a human capital perspective as institutions are forced to increase their employee base with specialists to identify and combat fraud.”

He goes on to explain that from a member’s perspective an increase in claim costs forces an organisation to increase premiums which negatively impacts the consumer/member’s pocket.

How GetSavvi Health actively helps prevent fraudulent or abusive activity:

“At GetSavvi Health we try to proactively identify fraud. It’s for this reason that we sms our members whenever we receive a claim from a provider,” Manual explains.

He further implores GetSavvi Health members to be vigilant when receiving these communications and to ensure that claims being made against their membership number are due to services rendered and not fraudulent transactions.

Manuel further stresses that, in addition to this, it’s important for members to give feedback in relation to their doctors’ visits.

“If they feel that a provider is calling them continuously for the same issues and does not address the issues properly, they should inform us so that we can have a conversation with the doctor to try to ensure ‘first-time fixes’ for our members.”

How to report fraudulent or abusive activity:

GetSavvi Health members are welcome to contact us at or contact our call centre on 0861 18 92 02 if they suspect fraud.
Members also have the option of reporting fraud to the Board of Healthcare Funders or the Health Professionals Council of South Africa.

Tips to prevent healthcare fraud or abuse:

Bundle Your Cover:
Funeral, Medical & Emergency for the whole family!

You might also like...

GP visits Product info

Day-to-day Benefits Explained

Emergency benefit Product info

FAQ: GetSavvi Health Emergency Benefits

Protect your family's health Product info

GetSavvi with Your Family’s Health

Primary healthcare for good health. Product info

Primary healthcare explained

No joining fees • Covers you and your immediate family • Get covered in under 10 minutes!

Not sure which plan is right for you? Compare all the plans or we can call you to chat about your needs.

Get A Quote