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Welcome to HFMU

Our core focus is to
facilitate a unified approach
against healthcare fraud.

Hello There

We Are HFMU

The Healthcare Forensic Management Unit (HFMU) is an information and resource sharing group which enjoys the participation of the majority of medical schemes, administrators, management and administration entities and some insurers.

The core focus of this unit is to facilitate a unified approach with regards to fraud in the medical schemes environment. This is achieved by sharing information regarding fraud, over billing and over servicing in order to minimise fraud across the industry and to protect medical schemes from healthcare providers and medical scheme members who shift their wrongdoings from one medical scheme to another once "caught out".

114
Entities
4
Countries
417
Investigations
67
Million consultations

What We Do

Information sharing and collaboration

Request information

Participants can request that other users provide them with information. The request will be distributed to all HFMU participants, and members can provide feedback on the system in the tab where it states, "provide feedback on request".

Share investigations

Participants can load cases which they have investigated and have confirmed that the perpetrator is guilty of fraud or misconduct. In the event where the matter has been taken further (e.g. saps case, hpcsa etc.), participants will be able to provide an update on the status of the case once the outcome has been received.

Provider lookup

Lookup providers and provider numbers linked to providers. Also a monthly report of all newly registered provider numbers.

View reports

All investigation cases which have been uploaded by members will be available on this tab for members to view.

Data sharing

Exposure analysis on shared claims data.

Realtime notifications

Receive daily notifications on all portal activity.