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Medicare fraud has become a widely publicized and costly issue. Although most doctors and other health care providers who work with Medicare are honest, you need to be aware of those cases where fraud may exist.
Fraud Prevention Tips
Fraud is defined as obtaining or attempting to obtain services or payments by dishonest means, with intent, knowledge, and willingness. The following is a list of tips to help you prevent fraud:
- Review Your Medicare Summary Notices. Check to see if you recognize the date(s) of service, the name of the doctor, the location of the facility, and the services you received. If you find an error, call Medicare.
- Protect Your Medicare Number. Handle your Medicare card as if it were a credit card. Only give out your number to your treating physician and others who you know to be legitimate.
- Be Aware of Your Needs. Do not let anyone convince you to see a doctor for a service you know you will not need.
- Remember that Nothing is Ever Free! Be aware of anyone who offers you a free service in exchange for your Medicare number.
- Ask Questions. You have the right to know about your medical care. Do not be afraid to ask questions.
- Avoid the "We Know How To Bill Medicare" Scam. If someone tells you that they know how to bill Medicare to get an uncovered item paid for, you should automatically know there is something wrong. Call your Medicare office.
- Never accept medical supplies from a door-to-door salesperson.
- Never allow television, radio, or advertising to influence your health-related decisions.
- Do not accept offers of money or gifts for medical care.
- Finally, educate yourself about Medicare.
How to Report a Complaint
If you believe fraud has taken place, you can report a complaint by calling 1-800-MEDICARE (1-800-633-4227), or by writing to us at the address below:
Upstate Medicare Division
PO Box 5200
Binghamton, NY 13902-5200
Before contacting the Upstate Medicare Division, please carefully review the facts as you know them, and as shown on your Medicare Summary Notices. Please write down the following:
- The provider's name and any identifying number you may have.
- The item or service you are questioning.
- The date on which the item or service was reported furnished.
- The amount approved and paid by Medicare.
- The date of the Medicare Summary Notices.
- The name and Medicare number of the person who was reported to have received the item or service.
- The reason you believe Medicare should not have made payment.
- Any other information you may have showing that the claim for the item or service should not have been paid by Medicare.
You can also report Medicare fraud by calling the Office of Inspector General's Hotline at 1-800-HHS-TIPS (1-800-447-8477).
If we are to maintain and sustain our current health care system, we must work together to reduce costs. |
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