GMF Health - Protecting your benefits
As a membership based not for profit organisation, GMF Health understands the importance of ensuring that its funds are properly protected and directed to where they are needed most - our members’ well being.
At the heart of its protection of those funds is the GMF Health Corporate Protection Policy, which sets in place procedures to prevent or detect inappropriate activities, which may result in the inappropriate payment of benefits.
The main objectives of the policy are to:
- Keep to an absolute minimum the payment of benefits involving wrongful activity;
- Where such activity is discovered, to recover benefits which have been inappropriately paid; and
- Where necessary, take legal or administrative action against those responsible.
To achieve those objectives, the GMF Health Group Loss Prevention and Awareness team:
- Undertake regular analysis and review of claims with a view to identifying irregular claiming patterns;
- Develop robust systems and procedures to prevent wherever possible inappropriate claiming in the first instance;
- Provide education and awareness training to GMF Health employees and medical providers to promote awareness of regulations and identification of wrongful claiming; and
- Where necessary gather evidence to support sanctions against those seeking to cause loss to GMF Health.
How you can help
A key part of protecting GMF Health funds is involving its members and Providers in the detection of those claims which may fall outside of those appropriate, due to either fraudulent activity or unprofessional practices.
If you suspect that someone may be causing a loss to the assets of GMF Health members you are encouraged to report those concerns to the Group Loss Prevention Team by:
Contacting them by telephone (08) 9265 8777; or
Emailing details of your concern to: GLPA@gmfhealth.com.au
Any contact you make with the Group Loss Prevention Team will be treated in the strictest confidence and you can raise your concerns anonymously if you wish.
Help protect the funds of GMF Health members by reporting your suspicions.