HEA-2025-0007
Healthcare Provider Fraud - Dr. Rajesh Doyle
Investigation into healthcare billing fraud involving claims for deceased patients.
OpenCritical

Ministries Involved

Ministry of Health

Assigned To

Dr. Nisha Bhakti

Data Intelligence Unit

Opened

2/15/2025

Financial Impact

$45,000

Entities Involved
Citizens and businesses linked to this case

Rajesh Doyle

citizen

View Profile
Related Alerts
Alerts that triggered or relate to this case

Healthcare Provider Billing for Deceased Patients

Dr. Rajesh Doyle

View Alert
Investigation Notes
Sarah Mohammed1 day ago

Completed review of all related pension payments. Total overpayment confirmed at $45,000 over 18 months. Preparing recovery recommendation.

Sarah Mohammed3 days ago

Cross-referenced death certificate with NIS records. Confirmed Maria Ramirez deceased Jan 10, 2024. Benefits continued to be collected through current period.

System1 week ago

Case created from Alert #A-2024-001. Initial investigation assigned to Sarah Mohammed.

Case Progress
Click steps to mark complete
Overall Completion50%
Quick Actions
AI Assistant
Suggested next steps based on case analysis

Review cross-ministry data

Entity appears in 3 ministry datasets. Check Inland Revenue for unreported income matching benefit claims.

Examine network connections

2 related entities share addresses. View relationship graph for full network picture.

Similar resolved cases

5 similar cases in past 12 months. 80% confirmed fraud. Avg recovery: $45,000.

Evidence Summary
Key documents and data points
Documents attached4
Cross-references verified7/9
Interviews conducted2
Ministry data sources3

AI-generated summary:

Strong evidence of benefit overpayment. Employment records from Inland Revenue contradict unemployment declarations. Bank records pending.

AI-Extracted EntitiesAI
Entities identified from attached documents by AI

Maria D. Ramirez

from Contract_2024_087.pdf

94%

Caribbean Supply Co.

from Contract_2024_087.pdf

91%

TTD 125,000

from Contract_2024_087.pdf

88%

March 15, 2026

from Contract_2024_087.pdf

96%

Anthony Doyle

from Board_Minutes.pdf

87%

Processed by AI Document Extraction

Recent Activity

Note added

Sarah M. - 1 day ago

Status updated

Sarah M. - 3 days ago

Case assigned

System - 1 week ago

Case created

System - 1 week ago