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Concerns are rising among Kazakhstan citizens regarding fraudulent claims for medical services they never received. These unauthorized services are being billed through the Social Health Insurance Fund (SHIF), leading to potential misuse of funds. Fortunately, there are ways to check your medical service history and prevent such incidents.

Understanding SHIF Fraud

Some medical facilities have been found to register doctor's appointments, laboratory tests, or other services under a patient's name without their actual participation. These facilities then claim payment from the SHIF. While illegal, these practices are reportedly occurring with some frequency. The SHIF itself acknowledges these issues, stating that unverified services are identified during monitoring.

Identifying Suspicious Claims

The SHIF has identified thousands of unverified services over the past three years. For instance, in 2023, 50.1 thousand cases were flagged. This was followed by 17.3 thousand cases in 2024 and a significant 56.2 thousand cases in 2025. These numbers translate to hundreds of millions of tenge in potentially misappropriated funds.

Checking Your Medical Service History

To verify which medical services have been registered under your name, you can utilize several online platforms:

These platforms provide details such as the date and type of service, the name of the medical institution, and the specialists who provided the care. However, some applications may not display the exact cost of the service.

When to Be Suspicious

You should be alerted if you notice services registered on dates you were not present, or if you were in a different city at the time of the claimed service. For example:

Reporting Irregularities

If you identify any suspicious services, your first step should be to contact the support service of the respective medical institution. If the issue remains unresolved, you can file a complaint with the SHIF through the eOtinish platform. Additionally, the soon-to-be-launched Qoldau 24/7 app will allow patients to confirm services or report violations.

If fraudulent claims are confirmed, the funds will be returned to the SHIF. Cases involving large sums are forwarded to law enforcement agencies. Medical organizations face fines, and in some instances, their contracts may be terminated.

Conclusion

While instances of fraud within the SHIF are occurring, it is not yet considered a systemic problem. However, it is crucial for every citizen to diligently monitor their medical service history. Utilize official platforms, keep your passwords secure, and take immediate action if you encounter any suspicious activity.