At CBHS we help you manage your health challenges. We believe in offering you the services, support and tools you need to live your best life.
Health and Wellness Programs are available to support eligible members towards a healthier lifestyle. Each Health and Wellness Program is subject to its own eligibility criteria.
Contact us for more information and to confirm your eligibility for a program.
Fraud and vigilance
Proudly not-for-profit since 1951
As a not-for-profit, member-owned health fund, we exist solely to serve our members. What does this mean for you? We pay members more in benefits than the industry average - and we've done so for the last decade1. Because providing quality, affordable health cover is our priority, now and into the future.
Preventing fraud
Fraud impacts us all. Every case of fraudulent claiming contributes to costs, which can then lead to higher premiums. We have a zero-tolerance policy for inappropriate claiming. Insurance fraud is a serious criminal offence.
Our investigations team identifies fraud and prosecutes offenders. Read our recent article about two successful fraud prosecutions.
Examples of fraud
Insurance fraud can originate in a provider’s office, from the people covered by a membership or from the health fund.
Examples of insurance fraud include:
- Inaccurate recording or claiming of treatments and services.
- An agreement between a member and a provider to claim fraudulently.
- Claiming for services or treatments that were not provided.
- Altered receipts or falsifying documents.
- Allowing a non-member to use your CBHS membership card.
How to reduce the risk of fraud
There are steps that you can take to reduce the risk of fraud and inappropriate claims.
- Keep your CBHS membership card secure and never leave it with a provider. Treat your membership card as you would a credit card.
- Carefully review accounts and receipts before signing the paperwork.
- Report your lost, stolen or misplaced membership card to us immediately.
- The people named should be the ones who received the service or treatment.
- The number of services should be correct.
- The name of the provider should be the same as the provider who carried out the treatment or service.
- There should not be any benefits paid for quotes or for services that were not provided.
You should also periodically review your claims history in the Member Centre on our website. This shows benefits paid to you, and to providers on your behalf, using your membership card. (Please check the ‘Include provider remittances’ option to include payments to providers). This section also shows admissions to hospital and medical treatment. Contact us immediately if you notice any errors.
Member fraud
Our zero-tolerance policy for inappropriate claiming extends to members who knowingly attempt to defraud the fund by submitting false claims or colluding with providers to submit false claims.
For the benefit of other members, our fund rules allow us to terminate the membership of any member who behaves in this way.
Inform us of fraud
If you suspect someone is making fraudulent claims or if you have any queries about inappropriate claiming, contact us immediately. You should also let us know if there are errors on your claim history report on our website.
- Send an email to investigate@cbhs.com.au – for the attention of Head of Claims
- Contact our Member Care team on 1300 654 123