Health Insurance Conference reviews ways to stop fraud, misuse of health benefits

Oman Monday 25/September/2023 15:41 PM
Health Insurance Conference reviews ways to stop fraud, misuse of health benefits

Muscat: Tasks of the 14th Middle East Healthcare Insurance Conference (2023), hosted by the Sultanate of Oman for the fourth time in a row, kicked off in Muscat on Monday.

In the two-day event, held in cooperation with the Middle East Insurance Group, Oman was represented by the Capital Market Authority (CMA).

The opening ceremony was held under the auspices of Sultan Salim Al Habsi, Minister of Finance.

The conference, which saw a large turnout of regional and international participants, is exploring issues pertaining to the management of health insurance risks and controlling cases of fraud and misuse of health benefits, due to the fact that such acts have a negative impact on the quality and cost of insurance and health services.

The conference is attended by companies operating in the insurance sector and private health institutions.

Three sessions were held on the first day of the conference: The first dealt with Dhamani (my insurance) project, which was discussed by representatives of Oman Medical Association, the CMA, the Ministry of Health, insurance companies and reinsurance firms.

The participants elaborated on the most important challenges and the progress made in the project.

The second session looked into developments in regional markets and visions of parties operating in the field of compulsory health insurance in the region.

The session took note of the latest health insurance statistics in the Middle East region, as well as experiences of establishments espousing compulsory health insurance in the region.

The third session touched on the topic of management of fraud risks, as well as the visions of insurance companies, reinsurance companies, hospitals and claims' management establishments.

The session identified the most common methods of fraud and means of addressing them. It also looked into the functions of the most advanced fraud risk management systems.

On 26 September, the conference will discuss a different set of topics. Those include the use of advanced pricing methodologies for underwriting health insurance, exploring previous experiences in risk management, covering medical expenses and promoting comprehensive health coverage by providing sustainable financial resources.

The sessions will also discuss a working paper on the concept of comprehensive social commitment and responsible commercial enterprise in compulsory health insurance.

Other topics on the agenda include issues and challenges of claims' management and cost assessment in private health insurance .

A discussion session will be also held to focus on innovation in health insurance and means of harnessing technology, artificial intelligence and innovation as measures to deal with fraud, abuse and waste of resources.