FMC Network UAE is one of the leading Third Party Administration in the Health Insurance Service in UAE since 1997 with the concept of “Cost effective, Comprehensive & Affordable Healthcare for all”.

Contact Us

Dubai: 501, 5th Floor, Fahidi Heights
Khalid Bin Al Waleed Road
Bank Street, Bur Dubai
P.O.Box: 50430
Dubai, UAE
Contact Number:+971 43977841

Abu Dhabi: Abdul Raheem Al Ali Building,
M-2, Mezzanine Floor, Al Muroor Road,
Opposite Al Falah Etisalat
P.O.Box: 127452,
Abu Dhabi, UAE
Contact Number: +971 26414104

Prior Approvals/Call Centre Services 24*7/365 days

Working Hours

Monday to Friday
08:00 AM - 05:30 PM
Saturday
Closed
Sunday
Closed
Monday
8.00am - 5.30pm
Tuesday
8.00am - 5.30pm
Wednesday
8.00am - 5.30pm
Thursday
8.00am - 5.30pm
Friday
8.00am - 5.30pm
Saturday
9.00am - 2.00pm
Sunday
Closed
Health Insurance

AUDITING - FRAUD, WASTE & ABUSE

Our Services

AUDITING - FRAUD, WASTE & ABUSE

FMC Network UAE has two main mechanisms for applying providers audit process, Offsite and onsite audit.Our in-house medical audit team consists of medically qualified coders conducting offsite and onsite audit services to validate suspicious claims and ensure recovery of any overpaid claims. Our claims validation or audit services review claims for potential up-coding, billing for non-existent prescriptions, medical necessity, inflation of charges, duplicate billing and billing of non-rendered services. Our coding team also cover all other issues related to Fraud, Waste and Abuse.

Offsite analysis is based on a built in system rules engine that adheres to international standards. Evidence based healthcare management and benchmarking are combined with provider usage trend analysis to give a detailed body of data. The On-site audit is based on selection of the most suspicious files based on Data analysis, Incidental visits and Provider log feedback.