|Vol. 13, Issue 18 • September 8, 2014|
How can I protect myself from Medicare fraud?
I recently found out that my doctor billed Medicare for several medical tests that I never actually received. What steps can I take going forward to protect myself from Medicare fraud?
- Grace (Anchorage, AK)
Medicare fraud happens when doctors, providers, or individuals deceive Medicare into paying more than it should, or paying for services when it should not. This is against the law, and it can put the health and wellbeing of Medicare beneficiaries at risk.
There are steps that you can take to protect yourself from Medicare fraud and ensure that you still receive appropriate medical care. Here are some important tips:
If you receive a suspicious or confusing MSN or EOB, contact your provider or pharmacy first to ask for an explanation. Medical claims can be complicated to read, and reviewing them with your provider or pharmacy might reveal that the charges were legitimate or that a billing error was to blame.
If you are still unsatisfied with the answer you receive, or if you suspect fraud, you should report the issue. It is helpful to have as many details as possible when reporting suspected fraud, such as specific names, locations, and times. If you have Original Medicare, you can call 800-Medicare to report the suspected fraud. If you have a Medicare Advantage plan, you can call your plan directly. Regardless of whether you have Original Medicare or a Medicare Advantage plan, you can contact the Office of the Inspector General (OIG) at 800-447-8477. When Medicare investigates the potential fraud, your name will not be used if you do not want it to be. In many cases, Medicare will be unable to confirm the occurrence of fraud without your help.
|Adults need vaccines in the same way that kids do, and it is important to check your health records to be sure that you are up to date on your shots. The U.S. Department of Health and Human Services publishes recommendations for the vaccines that adults should receive on a regular basis. They recommend that adults receive certain vaccines, including:
Keeping your vaccines up to date is important to help protect you from serious diseases. The protections that you get from vaccines received as a child can wear off over time, and as you get older, you may be at higher risk for certain illnesses. Speak with your primary care doctor to make sure that your vaccines are up to date, and that you are receiving vaccines appropriate for your age and state of health.
Medicare Part B covers the flu shot for free once every flu season, and it will also cover the pneumonia shot for free at least once in your lifetime. Medicare Part D also covers Td and Shingles vaccines; call your Part D plan for the costs of these vaccines
|Medicare Rights University, a comprehensive online training curriculum for professionals, provides a guided learning experience complete with a self-assessment tool, in-depth and user-friendly Medicare content, quizzes to test your knowledge, and downloadable materials.
This unique resource provides professionals with a clear path to learning Medicare through a Core Curriculum—four levels of Medicare instruction designed to build on information learned as you progress through each level. Medicare Rights University also offers a Special Topics section which provides an in-depth look at subjects not covered in the Core Curriculum, such as Medicare’s coverage of durable medical equipment and Medicare from a policy perspective.
Check out Medicare Rights University today by going online and visiting www.medicarerightsuniversity.org.
Dear Marci is a biweekly e-newsletter designed to keep you — people with Medicare, social workers, health care providers and other professionals — in the loop about health care benefits, rights and options for older Americans and people with disabilities.
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