I do not have a role in the day to day operations of any private health insurance company. However, it is my understanding that each of the private health insurance companies has its own procedures in place to investigate instances where over-charging of customers for hospital treatments is identified and notified to the insurer.
In the case of the VHI, the Deputy may wish to note that VHI Healthcare has a Special Investigations Unit which specifically deals with this matter. Where an error in charging has been identified, VHI Healthcare notifies the provider in question and deducts the monies involved directly from the provider. The provider is also asked to ensure that their processes are amended to prevent any recurrence. If there are a number of queries or repeat occurrences of anomalies with a particular hospital or service provider, an audit is conducted to identify the extent of this practice, the level of monies to be repaid to VHI Healthcare, and the redesign of processes to prevent any reoccurrence of inappropriate billing.
Customers of private health insurers should contact their insurance company in the first instance if they are not satisfied with their statements or if their insurer has been charged for accommodation or treatments not received. It is then a matter for each individual insurer to ensure that necessary steps are taken to investigate and deal appropriately with the issues identified.