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| Medicare Billing Error or Medicare Fraud |
| Tracey Cousineau |
| 9/8/2008 |
Most Medicare payment
errors are simple mistakes and are not the result of physicians,
providers, or suppliers trying to cheat the Medicare system.
However, there are a few
individuals who are intent on abusing or defrauding Medicare; cheating
the program out of millions of dollars annually.
It is important to report
Medicare fraud as fraud can cost you higher Medicare premiums,
deductibles, co- payments and may
ultimately prevent Medicare from offering more services and better
coverage.
Medicare Fraud is purposely billing Medicare for services that were never provided or received. For example, your Medicare number can be used to bill Medicare for services and supplies you didn't need or want, services and supplies your doctor did not order, services and supplies you can't even use, and services and supplies you did not receive.
What can you do to prevent Medicare fraud?
You, as the Medicare
beneficiary, are the most important link in finding Medicare fraud
because you know better than anyone what healthcare services you have
received. Review your
Medicare Summary Notice when
you receive it, and make sure you understand all of the items listed.
You can visit the consumer Medicare website at
www.medicare.gov for information about benefits and
services offered by Medicare. If
you don’t remember a procedure that is listed, you can call your
physician, provider, or supplier.
You can also call or write Medicare at the name, address, and
telephone number listed on your
Medicare Summary Notice.
Have your
Medicare Summary Notice ready
when contacting Medicare so you can provide as much of the following
information as possible.
Medicare will then be able to assist you in understanding where the
mistake originated from - the doctors office or Medicare office.
·
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 supposedly furnished
- The amount approved and paid by Medicare
- The date of the Medicare Summary Notice
- The name and Medicare number of the person who received the item or service
- The reason you believe Medicare should not have paid