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Serving People

Informing seniors about how to prevent healthcare fraud

The Senior Medicare Patrol (SMP) helps seniors report and protect themselves from Medicare errors, fraud, and abuse. The SMP offers the following tips for seniors, and urges anyone who suspects these issues to contact them at 256-716-2442.

Protection

Protecting personal information is the best line of defense in the fight against healthcare fraud and abuse. Everyone can make a difference by taking an active role in protecting healthcare benefits.
  • Treat Medicare, Medicaid and Social Security numbers like a credit card number. Never give these numbers to a stranger.
  • Remember: Medicare doesn’t call or visit to sell anything.
  • Don’t carry Medicare or Medicaid cards unless they’re needed for doctor’s appointments, visits to a hospital or clinic, or trips the pharmacy.
  • Record doctor visits, tests, and procedures in a personal healthcare journal or calendar.

  • Save Medicare Summary Notices and Part D Explanation of Benefits and then shred these documents when they are no longer useful.

Detection

Even when every precaution is taken, there is a chance of becoming a target of healthcare fraud. There are a lot of ways personal information can be used without permission. Here are some steps to help detect potential errors, fraud, and abuse:

  • Always review Medicare Summary Notices (MSN) and Part D Explanations of Benefits (EOB) for mistakes. Access to current Medicare accounts is available 24 hours a day at www.MyMedicare.gov.

  • Compare MSNs and EOBs to a personal healthcare journal and prescription drug receipts to make sure they are correct.
  • Look for three things on billing statements:
    1. Charges for anything not received
    2. Billing for the same thing twice
    3. Services that were not ordered by the doctor

Reporting

Report any suspected errors, fraud, or abuse immediately to protect other people from becoming victims and preserve Medicare benefits. To report concerns and abuse:
  • For questions or inconsistencies in a Medicare Summary Notice or Part D Explanation of Benefits, call the provider or plan first.
  • If no resolution occurs with the provider or plan, call the local SMP at 1-800-243-5463.