Fraud Prevention

Protect Yourself Against Healthcare Fraud

The telephone rings and the voice on the other end says she’s a Medicare representative. She also says she can save you hundreds of dollars each month by signing you up for the new Medicaid Prescription Drug Coverage.

Your monthly prescription drug costs are high, so this offer seems timely. The caller offers to sign you up over the phone and asks you for your Medicare and checking account numbers. That’s when the conversation should end.

Protect yourself from Medicare errors, fraud and abuse.

Protecting your personal information is the best line of defense in the fight against healthcare fraud and abuse. Every day, consumers are ripped off by scam artists. Here are some tips to actively protect your healthcare benefits:

Don’t disclose. Treat your Medicare, Medicaid and Social Security numbers like a credit card number. Never give these numbers to a stranger.

Practice zero tolerance. Don’t fall for calls, visits or solicitations—Medicare doesn’t call, visit or try to sell you anything.

Safeguard your card. Don’t carry your Medicare or Medicaid card unless you need it. Only take it to doctor’s appointments, visits to your hospital or clinic, or trips to the pharmacy.

Keep records. Record doctor’s visits, tests and procedures in your personal health care journal or calendar.

File and discard. Save Medicare Summary Notices and Part D Explanation of Benefits. Shred the documents when they are no longer useful.

Learn to detect potential errors, fraud and abuse.

Even when you do everything right, there is a chance that you could be a target of healthcare fraud. There are many ways that your personal information can be used without your permission. What follows are steps to take to detect potential errors, fraud and abuse.

Review your Medicare Summary Notice (MSN) and Part D Explanation of Benefits (EOB) for mistakes. Access to your current Medicare account is available 24 hours a day by visiting www.MyMedicare.gov.

Compare your MSN and EOB to your personal health care journal and prescription drug receipts to make certain they are correct.

Look for three things on your billing statement:
1. Charges for something you didn’t get
2. Billing for the same thing twice
3. Services that were not ordered by your doctor

If you suspect you’ve been a target of errors, fraud, and abuse, report it immediately.

Not only do you protect yourself and help save your Medicare benefits, but you also protect others from becoming victims. Here are two quick steps to report errors, fraud and abuse:

First, call your plan provider. Discuss any questions you have about information on your MSN or Part D of your EOB.

Call your SMP (Senior Medicare Patrol). If you are not comfortable calling your provider or if you are not satisfied with the response you received, your SMP can be reached at 1-888-515-6565.

For additional information, contact Care Connection for Aging Services. To report suspected abuse, call 1-888-515-6565 or send email to information@goaging.org.

Return to the Home Page