Fraud policy
What is healthcare fraud?
We refer to healthcare fraud when someone deliberately breaks the rules to gain a financial advantage. This can involve insured individuals, healthcare providers, or others.
Examples include:
- submitting a bill for care that was not provided
- inflating a bill to receive a higher reimbursement
- spending personal care budget (PCB) funds on something other than care
By reporting potential fraud, you help keep healthcare fair.
How do we investigate a report?
If we receive a tip that something is amiss, we investigate the matter. We gather the information needed to properly assess the situation. We share our findings with those involved. Everyone gets the chance to tell their side of the story. This ensures we remain transparent and thorough.
What measures do we take in cases of fraud?
If fraud is confirmed, we follow the national guidelines of Zorgverzekeraars Nederland (ZN). Depending on the situation, we may:
- recover amounts paid out in error
- record data in the External Referral Register (EVR)
- terminate the insurance policy
- file a report with the authorities
Our approach is always appropriate and careful, ensuring that the measure is commensurate with what has occurred.
Report fraud
Do you suspect healthcare fraud? Let us know. Your tip helps keep the healthcare system honest. Send your report confidentially to specialezaken@salland.nl.