Forensic probe clears Mediclinic of billing corruption allegations
MEDICLINIC said yesterday an independent forensic investigation by law firm ENSafrica had cleared the private hospital group of allegations that it was involved in corrupt billing processes.
Mediclinic appointed ENSafrica to investigate allegations made against Mediclinic on August 22, 2023, and the hospital group said yesterday in a statement it had provided the law firm with unfettered access to investigate and determine whether there was any substance to the allegations made against the named six hospitals.
The probe began after a whistleblower, who claimed to be a former Mediclinic employee, emailed the principal officers of prominent medical schemes last year with information about what the person claimed to be their experience as a former clinical case manager at six Mediclinic hospitals.
ENSafrica also randomly selected a further six hospitals to test for billing irregularities.
Mediclinic said the investigation included interviews with staff, and more than 120 000 emails and documents were reviewed. No systemic issues were found by ENSafrica and “where areas for improvement were identified, they were being addressed,” Mediclinic said.
Mediclinic could not be reached for further comment yesterday.
Mediclinic treats more than 500 000 patients per year throughout southern Africa.
“The company remains committed to operating in an ethical and responsible manner. Its priority remains ensuring the welfare and trust of staff, patients and business partners, and pursuing its purpose of enhancing the quality of life,” the statement said.
Steven Powell, head of ENSafrica Forensic, said they were “very satisfied with the level of access Mediclinic provided to allow us to conduct a thorough investigation into the anonymous allegations”.
“The processes we investigated are complex and we found no evidence of an intentional practice of manipulating billing or coding at a group or hospital level.
“This is supported by the existence of multiple checks and balances on billing practices.
“We concluded that Mediclinic is an ethical organisation, which has a commitment to good governance as well as continuous improvement,” he said.
Mediclinic CEO Greg van Wyk said in a statement: “Our systems and culture have been rigorously tested throughout this process. The report is clear that the investigation found no evidence of systemic concerns and we are reassured by the outcome.”
Mediclinic said in response to BR questions that mistakes and unintentional errors occurred, and had been immediately addressed. “Mistakes and unintentional errors were found to happen from time to time as normal day to day business and are addressed as soon as they are identified.”