Backed by a robust system, GlobeMed Saudi has an experienced team dedicated to perform medical post-billing audit allowing us to detect and manage cases of fraud, waste or abuse that could be identified throughout the claims management lifecycle:

• Fraud and abuse detection flagging suspected claims for further investigation.
• Automated medical rules engine providing real-time detection of medical discrepancies, misuse or waste.
• Special applied controls on suspected flagged doctors.
• Mystery shoppers and outbound surveys.
• Post payment audit allowing to take a closer look at suspected cases, allowing to further investigate, gather proofs in order to confirm or deny the suspicion.