State-owned health insurer VHI recovered €24.8 million from “inappropriate billings” last year, the health insurer has said.
The recovery comes following reviews of invoices by the insurer’s special investigation unit. Established in June 2009, this unit follows up on suspected cases of billing errors by providers or overcharging, and has recovered almost €151.6 million to date.
VHI said all savings recovered from investigations are returned to the customer through “enhanced product benefits”.
The figures come as VHI announced a net surplus of €82.4 million for 2018, up from €75.3 million a year earlier. The surplus before tax was €92.4 million as against €86.3 million in 2017.
VHI, which has yet to publish its annual report for 2018, said gross earned annual premium slipped from €1.48 billion to €1.41 billion.
Income from insurance products and services other than private health insurance amounted to €31.2 million during the year up from €27.8 million in 2017.
The insurer recorded a rise in members to 1.106 million from 1.075 million. VHI said it paid out €1.33 billion in 2018 and covered almost 1.206 million claims over the year.
Cancer
The most significant area of claims expenditure was cancer and related care at €174.3 million.
“In 2018 we approved drugs, procedures and technologies making sure that our customers continue to have access to the latest innovative treatments, medicines and technologies available. Last year we also approved new benefits covering genetic testing for hereditary cancer and molecular profiling for malignant tumours,” VHI chief executive John O’Dwyer said.
Efficiencies
He added that while the private health insurance market was expanding on the back of a growing economy, there was a need to improve the risk equalisation system so that insurers are rewarded for delivering efficiencies and providing better health outcomes, rather than just selecting better risks. “Now is the time to take those steps,” said Mr O’Dwyer.
