How many times have you visited your doctor and never even thought twice about how they bill your Medicare?
If you are like most people out there, the answer is not very often since you are dealing mostly with honest doctors and health care providers who bill Medicare accurately for services or supplies that they provide you. However, resent research indicates Medicare fraud is on the rise and some people who provide you with health care services and supplies attempt to defraud the Medicare system.
Medicare.gov describes Medicare fraud as a person, group or company billing Medicare for services or goods that a senior never received.
These people or companies are able to bill counterfeit claims to Medicare because they have gained access to a senior’s Medicare data and social security numbers. If this has happened to you, you might not realize your Medicare information has been stolen or misused unless you are paying particular attention to your Medicare statement and other related documents.
According to the website www.stopmedicarefraud.gov, fraud examples include:
- A health care provider bills Medicare for services or supplies never received by the senior.
- A company offers a senior a Medicare drug plan not approved by Medicare or misleads a senior with false information to join a Medicare plan.
- A person uses a senior’s Medicare card to acquire medical care or equipment.
- A person bills Medicare for home medical equipment after returning it.
The U.S. Department of Justice works closely with the U.S. Department of Health and Human Services (HHS) to eliminate Medicare fraud by investigating claims that you and others report. Peter Budetti, deputy administrator and director of the Center for Program Integrity at the federal Centers for Medicare and Medicaid Services, says that sometimes seniors feel as if complaints have fallen on deaf ears, but in reality, the agency does its best to investigate all suspicious activity. He recommends that seniors need to be patient after filing a claim.
“In 2011, calls to our 800-number triggered 30,000 investigations,” he added. “Just because we don’t call you back don’t mean your complaint isn’t being investigated.”
Medicare fraud ends up costing the government and health care consumer like you millions of dollars every year because health care costs rise as a result of Medicare fraud. Fortunately, you can help fight the deception and actually be on the front lines of the battle against fraud by following these three guidelines:
- Guard your personal information.
- Closely examine your important paperwork, specially your Medicare statements.
- Be aware of any health care providers or equipment suppliers who sell over the television, over the phone or the internet.
When you notice any suspicious charge or service claims, contact your provider immediately for clarification. If a the provider does not give you an explanation for the charge, the explanation doesn’t match the services or goods received, or the provider cannot be reached, immediately contact Medicare at 1-800-MEDICARE (1-800-633-4227), call the inspector general at 1-800-HHS-TIPS (1-800-447-8477) or email HHSTips@hhs.gov.
The website www.stopmedicarefraud.gov is full of additional information about how to guard against Medicare fraud and report suspicious activity.
For more information:
- Keeping Your Bank Account Safe from Fraud by the Society of Certified Senior Advisors
- Elder Investment Fraud and Exploitation brochure by the Baylor College of Medicine
- National Center on Elder Abuse
Stanton Lawson is the Co-Owner of Sequoia Senior Solutions. Sequoia’s mission is to ensure a better quality of life for their elderly clients and their families, by providing dependable and affordable in-home care. Sequoia’s focus is to keep you or your loved ones at home and avoid:
- Loss of friends and possessions
- Loss of independence and freedom
- Loss of spirit which is drained by the battles of daily living
Sequoia Senior Solutions, Inc. serves Napa, Sonoma, Marin, Solano, Mendocino, Lake Counties. The main office is located at191 Lynch Creek Way, Suite 102, Petaluma, CA 94954. Email email@example.com Tel: (707) 763-6600 Fax: (707) 763-6607, www.sequoiaseniorsolutions.com.