A consultant plastic and reconstructive surgeon has repaid over £100,000 to Axa PPP Healthcare, avoiding court proceedings.
Surgeon Ciaran Healy has repaid over £100,000 to the provider after it instigated an investigation into mis-billing, as well as Axa’s legal costs.
The mis-billing relates to treatments Healy was providing at private clinics including the Wellington Hospital in London. The claim was settled without admission of liability in advance of proceedings being issued in the High Court.
Axa PPP undertook an audit of Healy’s billing practice that revealed a pattern of billing that ‘did not appear reflective of the level of clinical intervention expected or required’ and charges for an unexpected and unexplained number of additional services.
Axa PPP head of investigations Dr Simon Peck says: “We work hard to protect customer premiums by ensuring that medical treatment is billed to us correctly. Most of the billing we receive is entirely reasonable but some is not. We use analytics to identify anomalies which we then investigate. In addition to this case we have also this month seen a number of other significant financial settlements achieved by negotiation with providers and their legal representatives; demonstrating the continuing success of our Provider Investigations Team.”