Who's the MC King in your office?
Published on Apr 20, 2014 11:44 AM
A medical network that began to help small clinics band together and cut costs has grown a unique computerised database capable of tracking everything from the ailments affecting a company's workforce to spotting crooked doctors.
Singapore-grown Make Health Connect, better known as MHC, handles 1.5 million medical claims a year from doctors in Singapore alone. It found that the information it gathered provided valuable insights into practices and trends on the ground.
MHC founder Low Lee Yong told The Sunday Times: "Medical claims processing is a very expensive and tedious game. The idea was to link everyone up, simplify procedures and make things paperless.
"But in the process, the network started collecting information which was captured at the point of consultation such as why doctors gave sick leave, and what medication they prescribed for what sort of pain."
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"Who are the staff jumping from clinic to clinic getting medical certificates just to take advantage of the 14 days of medical leave they get each year? And who are those who still come to work despite getting MCs? Such information can help us manage our staff better."
MS MAUREEN TAN, HR director at UTC Aerospace Systems, which has used MHC's data to better manage the health of its employees
One patient, 101 visits to same clinic in a year
Something did not look right, when the Make Health Connect (MHC) database picked out a patient who appeared to have visited the same clinic 101 times over a single year.
Investigations revealed that a nurse at the clinic had forged the patient's signature so that the clinic could claim more consultation fees from the patient's employer.
MHC alerted its client, the patient's employer, and a police report was made.
In the last six months alone, data collected by the MHC network of clinics has helped insurance companies and employers recoup more than $300,000 in fraudulent claims by errant clinics.
In one case, a doctor landed in hot water after MHC founder Low Lee Yong noticed he made numerous prescriptions for an expensive painkiller. The doctor, it turned out, was making false claims.
"We helped our client, an insurance company, recoup more than $80,000 from the doctor," said Dr Low.
MHC also found a doctor prescribing medication he did not even stock, and another who apparently prescribed a lotion for head lice to patients with coughs, rashes and colds.
"In Singapore, there are hardly any cases of scalp lice," said Dr Low, a former general practitioner who started MHC in 1994.
In all the cases mentioned, the doctors blamed human error for their wrong claims and made full restitution. But they were all expelled from the MHC network.
"We do not tolerate any lack of integrity," said Dr Low.
In cases of suspected unethical practices by doctors, MHC works with its clients to decide on the course of action. Some doctors have been expelled from the network; others have been reported to the police.
Asked if this feature would deter doctors from joining MHC, Dr Paul Choo - the founder of the Shenton Medical Group who now sits on MHC's board of advisers - said the benefits of joining the network are more important to clinics.
"Most doctors are honest but sometimes they just want to test the system. They think, 'I'm not cheating the patient, I'm cheating the insurance company.'
"All doctors know that their misdemeanours can be picked up, just as they know they cannot cheat the income tax department."
Wong Kim Hoh