This month, we are raising awareness about benefits fraud and sharing practical steps you can take to help protect your benefits.
What is benefits fraud?
Benefits fraud includes:
- Billing for services not received
- Falsifying health conditions
- Inflating claims
- Sharing benefits with ineligible individuals
The part we play in protecting our benefits
While Sun Life uses several measures to address fraudulent claims, there are a few ways plan members can contribute to the sustainability of the benefit plans. Here are some tips to keep in mind:
Know your plan
Understand what’s covered. That way you can use the benefits to their fullest, and there is value for all benefit plan members
Know your transactions
Sun Life does a great job of keeping you updated on claims made to the plan. It is always a good idea to review these transactions as though they took place directly with your banking institution.
Protect your info
Don’t share your benefits ID or drug card with non-dependent benefit plan members. Fraud can also look like bad actors using your information to make claims. There are also a range of scams and other efforts to take money from plan members through the plan. These include fraud and scam efforts like fake lotteries, personal loans, and wire transfers. Stay vigilant and do what you can to protect your identity.
Avoid delisted providers
Sun Life will investigate and disallow certain healthcare service providers, clinics, facilities, or medical suppliers from claims processing and reimbursement. Sun Life does this to better protect the benefits plans.
You can double-check that you aren't using an inappropriate provider by reviewing Sun Life’s Delisted providers' information.
- Sign in to www.mysunlife.ca
- Navigate to the Benefits Centre
- On the navigation on the right, you will see “Delisted providers list”
By avoiding these providers, you can ensure your claim does not get rejected.
Report suspected fraud
If something doesn’t seem right, contact Sun Life’s fraud department.
Posted in Articles
Tagged
- HR
- Benefits FYI