{"id":2735,"date":"2018-06-12T15:30:17","date_gmt":"2018-06-12T18:30:17","guid":{"rendered":"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/?p=2735"},"modified":"2022-05-05T22:00:39","modified_gmt":"2022-05-06T01:00:39","slug":"fraudes-nos-planos-de-saude","status":"publish","type":"post","link":"https:\/\/segurosinteligentes.com.br\/oldrh\/fraudes-nos-planos-de-saude\/","title":{"rendered":"Voc\u00ea conhece o impacto das fraudes nos planos de sa\u00fade?"},"content":{"rendered":"<p>[et_pb_section admin_label=&#8221;section&#8221; transparent_background=&#8221;on&#8221; background_color=&#8221;#ffffff&#8221; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;on&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221; custom_padding=&#8221;0px||50px|&#8221;][et_pb_row admin_label=&#8221;row&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;on&#8221; width_unit=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221; padding_mobile=&#8221;on&#8221; allow_player_pause=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; make_equal=&#8221;off&#8221; parallax_1=&#8221;off&#8221; parallax_method_1=&#8221;off&#8221; parallax_2=&#8221;off&#8221; parallax_method_2=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221; custom_padding=&#8221;50px|35px|50px|35px&#8221; background_color=&#8221;#ffffff&#8221;][et_pb_column type=&#8221;2_3&#8243;][et_pb_text admin_label=&#8221;tag e data&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;|on|||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#9ec31e&#8221; text_line_height=&#8221;1.5em&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; custom_margin=&#8221;||0px|&#8221;] FRAUDES | 12.JUNHO.2018 [\/et_pb_text][et_pb_text admin_label=&#8221;t\u00edtulo&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;|on|||&#8221; text_font_size=&#8221;32&#8243; text_text_color=&#8221;#495358&#8243; text_line_height=&#8221;1em&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<h1>Voc\u00ea conhece o impacto das fraudes nos planos de sa\u00fade?<\/h1>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;conte\u00fado&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_text_color=&#8221;#748690&#8243; text_line_height=&#8221;1.5em&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>O desperd\u00edcio de recursos por conta de fraudes nos <a href=\"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/?s=%22planos+de+sa%C3%BAde%22\" target=\"_blank\" rel=\"noopener\">planos de sa\u00fade<\/a> \u00e9 um dos grandes males do mercado. Desde aquela pessoa que divide o recibo a fim de obter o reembolso total de uma consulta, passando por outra que arranja um atestado m\u00e9dico falso para abonar a falta no trabalho, o efeito \u00e9 o mesmo: contratos mais caros e preju\u00edzo para todos os envolvidos. Principalmente para os benefici\u00e1rios.<\/p>\n<p>S\u00f3 em 2018, cerca de R$ 24 bilh\u00f5es dos gastos das operadoras m\u00e9dico-hospitalares foram consumidos indevidamente por fraudes e desperd\u00edcios com procedimentos desnecess\u00e1rios, aponta o\u00a0<a href=\"https:\/\/www.iess.org.br\/\" target=\"_blank\" rel=\"noopener\">IESS (Instituto de Estudos da Sa\u00fade Suplementar)<\/a>.<\/p>\n<p>Agora, imagine se pelo menos metade do montante acima pudesse ser aplicado nos benef\u00edcios oferecidos pelos planos de sa\u00fade? Isso resultaria, no m\u00ednimo, em uma melhor cobertura m\u00e9dico-hospitalar por parte das operadoras.<\/p>\n<p>&nbsp;<\/p>\n<h2>O que \u00e9 considerado fraude nos planos?<\/h2>\n<p>Confira alguns exemplos:<\/p>\n<ul>\n<li>Dividir o recibo para obter reembolso total de uma consulta;<\/li>\n<li>Obter ilegalmente atestados e laudos m\u00e9dicos com o objetivo de aumentar o per\u00edodo de licen\u00e7a remunerada, por exemplo;<\/li>\n<li>Concordar com o pagamento por procedimentos n\u00e3o realizados ou indevidos;<\/li>\n<li>Omitir a exist\u00eancia de doen\u00e7a preexistente na declara\u00e7\u00e3o de sa\u00fade;<\/li>\n<li>Emprestar a carteira pessoal do plano de sa\u00fade para o uso de terceiros.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/o-que-fazer-quando-nao-ha-medico-disponivel-na-minha-cidade\/<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243;][et_pb_sidebar admin_label=&#8221;Barra Lateral&#8221; global_module=&#8221;399&#8243; orientation=&#8221;left&#8221; area=&#8221;sidebar-1&#8243; background_layout=&#8221;light&#8221; remove_border=&#8221;on&#8221; body_line_height=&#8221;1.5em&#8221; custom_css_widget=&#8221;margin-bottom: 30px !important;&#8221; saved_tabs=&#8221;all&#8221;] [\/et_pb_sidebar][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Se\u00e7\u00e3o&#8221; global_module=&#8221;93&#8243; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f9f9f9&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;on&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221; custom_padding=&#8221;20px||20px|&#8221;][et_pb_row global_parent=&#8221;93&#8243; admin_label=&#8221;Linha&#8221; make_fullwidth=&#8221;on&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;2&#8243; padding_mobile=&#8221;off&#8221; allow_player_pause=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; make_equal=&#8221;off&#8221; parallax_1=&#8221;off&#8221; parallax_method_1=&#8221;off&#8221; parallax_2=&#8221;off&#8221; parallax_method_2=&#8221;off&#8221; parallax_3=&#8221;off&#8221; parallax_method_3=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221; module_class=&#8221;footer&#8221; module_id_1=&#8221;coluna_1&#8243; module_id_2=&#8221;coluna_2&#8243; module_id_3=&#8221;coluna_3&#8243; module_id=&#8221;footer_1&#8243;][et_pb_column type=&#8221;1_4&#8243;][et_pb_text global_parent=&#8221;93&#8243; admin_label=&#8221;logo it&#8217;sseg&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;] <img decoding=\"async\" class=\"alignleft size-full wp-image-82\" src=\"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/wp-content\/uploads\/logo-seguros-inteligentes.png\" width=\"270\" \/> [\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text global_parent=&#8221;93&#8243; admin_label=&#8221;copyright&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;right&#8221; text_line_height=&#8221;1.5em&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; custom_padding=&#8221;|||20%&#8221; text_font=&#8221;Abel||||&#8221;] PORTAL RH IT\u2019SSEG \u00e9 uma publica\u00e7\u00e3o da It\u2019sSeg Seguros Inteligentes. 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[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row global_parent=&#8221;93&#8243; admin_label=&#8221;Linha&#8221; make_fullwidth=&#8221;on&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;2&#8243; padding_mobile=&#8221;off&#8221; allow_player_pause=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; make_equal=&#8221;off&#8221; parallax_1=&#8221;off&#8221; parallax_method_1=&#8221;off&#8221; parallax_2=&#8221;off&#8221; parallax_method_2=&#8221;off&#8221; parallax_3=&#8221;off&#8221; parallax_method_3=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221; module_id_3=&#8221;coluna_3&#8243; module_id=&#8221;footer_2_2&#8243; custom_padding=&#8221;0px|||&#8221;][et_pb_column type=&#8221;1_2&#8243;][et_pb_text global_parent=&#8221;93&#8243; admin_label=&#8221;logo it&#8217;sseg&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; module_id=&#8221;logo_itsseg_footer_1&#8243;] <img decoding=\"async\" class=\"alignleft size-full wp-image-82\" src=\"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/wp-content\/uploads\/logo-seguros-inteligentes.png\" width=\"270\" \/> [\/et_pb_text][et_pb_text global_parent=&#8221;93&#8243; admin_label=&#8221;logo it&#8217;sseg&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;center&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; module_id=&#8221;logo_itsseg_footer_2&#8243;] <img decoding=\"async\" src=\"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/wp-content\/uploads\/logo-seguros-inteligentes-mobile.png\" alt=\"logo_footer_2\" width=\"70\" \/> [\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text global_parent=&#8221;93&#8243; admin_label=&#8221;logo portal&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;right&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; module_id=&#8221;logo_portal_itsseg_footer_2&#8243;] <img decoding=\"async\" class=\"alignright size-full wp-image-83\" src=\"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/wp-content\/uploads\/portalrh-footer.png\" alt=\"logo_portal_footer\" width=\"270\" \/> [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Saiba como as fraudes impactam diretamente os planos de sa\u00fade.<\/p>\n","protected":false},"author":1,"featured_media":2736,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_links_to":"","_links_to_target":""},"categories":[13],"tags":[367],"_links":{"self":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2735"}],"collection":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/comments?post=2735"}],"version-history":[{"count":5,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2735\/revisions"}],"predecessor-version":[{"id":9267,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2735\/revisions\/9267"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media\/2736"}],"wp:attachment":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media?parent=2735"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/categories?post=2735"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/tags?post=2735"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}