While checking statements from health insurers a number of people have noticed Covid tests that were never administered. One individual in St. Gallen discovered 30 Covid tests billed by a doctor in Vaud on their statement, reported RTS.
A spokesperson for Santésuisse, a health insurance association, said the organisation estimates that 1% of Covid tests have not been billed correctly and could be fraudulent. The total value of these potentially fraudulent tests could reach CHF 20 million, he said.
The role played by the different parties in the false billing of these tests, a process dubbed factoring, has not yet been established. The way it works is someone buys invoices for thousands of tests from a test centre. But because only medical professionals can submit invoices to health insurance companies the owner of the invoices must pass them to a doctor for processing. Once processed, the doctor receives payment and then passes it back to the original invoice purchaser after deducting a commission. Both the buyer of the invoices and the doctor make money from the process.
Where, when and whether non-existent invoices were added to the process is the key to establishing culpability.