Tips to Avoid Medicare Fraud

Medicare fraud and abuse is a serious crime to report immediately. Medicare fraud can come in many forms but generally involves the illegal practice of falsifying Medicare claims to receive higher financial compensation. Some common instances of Medicare fraud include:

• Billing for services above and beyond those performed
  
  
• Billing for canceled or no-show appointments
  
  
• Billing for supplies that were never delivered or not provided
  
  
• Billing for services not performed at all
  
  
• Receiving kickbacks and/or incentives for referrals
  
  
• Unnecessary ordering of medical services or tests for patients
  
  
• Unnecessary ordering of medical supplies for patients
  
  

One other form of Medicare fraud involves identity theft. This can occur when a person’s Medicare information is stolen and used to submit fraudulent claims. There are ways to spot Medicare fraud. Ways to spot Medicare fraud include:

• Comparing the days and services on your calendar with the statement you receive from Medicare to ensure you got each service listed, as well as ensuring that the details are correct
  
  

• Details include the “Medicare Summary Notice” if you have Original Medicare or similar statements for those with a Medicare Advantage Plan. These notices will list the services you received or the prescriptions you filled
  
  
• Make sure to check your claims early. The sooner you spot an error, the sooner you’ll be able to help stop the fraud. You can either log into your Medicare account or call the Medicare line to view your Original Medicare claims as soon as they are processed
  
  

• Checking the receipts and statements you receive from the providers for mistakes
  
  

Here are some things you should and shouldn’t do to prevent Medicare:

DO’S

• Protect your Medicare Number as well as your Social Security number
• Use a calendar to track all your doctor’s appointments and any services you received
• Stay up to dates on recent scams
• Know what a Medicare plan can and can’t do before you join
  
  

DON’TS 

• Give out your Medicare number or Social Security number to anyone except for your doctor or people that already have it
• Accept money or gifts in exchange for free medical care
• Contact your doctor to request services you don’t need
• Share your medical records with anyone

If you suspect that you are a victim of Medicare fraud and abuse, you can call 1-800-MEDICARE, for Medicare Advantage Plans, 1-877-7SAFERX (1-877-772-3379).