Defence Health behavioural analysis
The Association has been advised by Defence Health that they will be conducting a peer behavioural analysis of their remedial providers over the next twelve months, commencing on 1 January 2025. Defence Health are sharing this information proactively in advance to maintain transparency and provide you with an opportunity to address any concerns or queries.
Their decision to undertake this analysis stems from patterns observed in claims data, including instances of:
- Billing for multiple initial consultations per patient, which attract higher charges and benefits.
- Using HICAPS cards to claim for multiple individuals on the same policy in a manner that may inadvertently provide a single patient with a higher benefit and reduced out-of-pocket costs.
Should you have any questions, please do not hesitate to contact Defence Health directly at extras.integrity@defencehealth.com.au