Medicare fraud is something that greatly undermines the sustainability and effectiveness of the Medicare program and has an impact on the individual premiums and deductions each person pays. It is estimated that in 2014, somewhere between $17 billion and $57 billion was paid out to fraudulent claims.
While improper billing is the most common type of Medicare fraud, there are also cases of Medicare ID theft, and people getting conned into signing up for things they don’t understand with Medicare being billed on their behalf.
How to protect yourself from Medicare Fraud
- Maintain a calendar and add an entry every time you visit your doctor. Note down your provider, what you visited for and if any tests were performed or medical equipment used.
- After you finish with the doctor, ask for the paperwork regarding the visit before checking out.
- In case you have enrolled for Medicare, you will receive a Medicare Summary Notice or (MSN). If you are enrolled with other health insurance providers you will receive an EOB or explanation of benefits.
- Make sure that your MSN or EOB tallies with the paperwork that you have received from your healthcare provider and your calendar. In the case of any discrepancies, speak with your healthcare provider, asking for clarification, and then you can report it to Medicare as possible fraud.
Reporting Medicare Fraud
In the case of any discrepancies from providers over documentation or services provided to you, if you suspect fraud, call 1-800-MEDICARE or file a report online. Make sure you have all the required information and documentation. In the case of it being confirmed as fraud, in some cases, you may even earn a reward of up to $1000.
Important guidelines to remember
- Be wary of offers and promotions that may have hidden costs that may be billed to you.
- Do not share your Medicare information with anyone except state-certified healthcare providers, and only when receiving any medical care.
- Receiving any money or kickbacks for using a service from any health care provider is illegal and a sign of blatant fraud.
- Don’t be intimidated or coerced to agree to expensive medical procedures or tests by your healthcare provider. Always get a second opinion.
Protect your Medicare cards like you would your credit card and protect yourself from identity fraud.