Many inappropriate claims happen because of misinformed or misled plan members, or dishonest service providers.
Like other companies, we have the necessary procedures in place to handle a fraudulent event when it happens, but the key to success is avoiding getting to that point. Here at Manulife we take a different approach to fraud prevention – a positive and proactive one.
Helping you inform your plan members on how to use their plan, and working closely with health care providers is our priority.
We do this to help protect your plan from misuse and abuse so you don’t incur extra costs.
Fully engaged, well-informed plan members help protect your plan. It’s important members understand that having a benefits plan is a privilege. And proper use of the program is an expectation not a request.
We help you do this!
Here’s where our proactive strategy really kicks in. It’s not just engaged and aware plan members that can help protect your plan. We want to help our clients work with professional, ethical service providers.
So, we’ve created an innovative new program, which identifies providers who demonstrate ethical business practices, providing an additional level of protection for your plan.
A solid foundation
When misuse and abuse happens, we’re on it! As you should expect from your group benefits provider, we use state of the art data analytics systems and processes, sophisticated claims systems and plan design to proactively and reactively protect your plan. We have a dedicated team of over 70 prevention and investigation experts, who work closely with law enforcement professionals to protect your plan and your plan members. And we prosecute those found responsible for fraudulent activity
Ready-to-use campaigns – created for you.
Use these campaigns to engage your members and set clear expectations and standards for your company. You can empower your members to make smart decisions when submitting their claims, and promote a sense of ownership, encouraging them to protect your plan from risk.
Identify the three most common and wrongly claimed products and services that are not covered.
Protect what’s yours
Encourage plan members to look for the three most common wrongly claimed products and services. And to tell us if they spot anything suspicious.
Be part of the solution