WILLEMSTAD – The Social Insurance Bank (SVB) has taken action to recover money improperly paid to healthcare providers after investigations uncovered cases involving questionable billing practices, including claims submitted for services performed by individuals who were not registered with SVB.
The findings are part of intensified controls by SVB aimed at determining whether healthcare claims submitted under Curaçao’s public insurance system correspond with services actually provided.
One practice identified by investigators involved healthcare providers officially registered with SVB submitting invoices for treatment that had actually been provided by people who were not registered with the agency.
In some of those cases, according to SVB, the registered healthcare provider was not present at the practice or was not even in Curaçao when the treatment was provided.
SVB said measures have been taken in such cases, including recovering amounts that had been paid improperly.
Investigators have also identified claims for treatment that never took place, duplicate billing and discrepancies between the amount or type of healthcare declared and the services patients actually received.
The findings underline the importance of patients themselves in detecting possible irregularities.
SVB is therefore asking insured residents to contact the agency if they discover that they are being treated by a healthcare provider other than the one to whom they were referred, or if they suspect that invoices submitted in their name do not accurately reflect the healthcare services they received.
Reports can be made to SVB's Complaints Department by telephone at 434-4138, by email at svb@svbcur.org or through WhatsApp at +599 9 434 4000.
SVB said information received from insured residents remains crucial because it can help investigators compare billing records with what patients actually experienced.
The agency is combining these reports with artificial intelligence, advanced data analysis, inspections and interviews to identify and verify suspicious billing patterns.
Depending on the case, investigations can involve insurance inspectors, special enforcement officers, physicians and other medical experts, billing specialists, lawyers and data analysts. SVB can also cooperate with other Curaçao authorities when necessary.
The intensified controls are intended not only to detect improper claims but also to safeguard Curaçao’s limited healthcare resources and ensure public funds are spent on legitimate patient care.