How to Help Prevent Medicare Fraud

Word fraud in letters on background of dollar banknotesUnfortunately, we live in a world where some people prey on unsuspecting innocents. By providing fraudulent information, many elderly are being taken advantage of by unscrupulous people who would manipulate them out of their money and private information.

 

As a caregiver protecting a dependent senior, the best course of action is defense. Here is a checklist to help protect your patient or loved one’s health care benefits.

 

Protecting Your Personal Information

If anyone asks for any information that seems too personal, it probably isn’t information that they should have. Do not give out social security information, Medicare, Medicaid, account information, or an address to strangers even if they seem legitimate. To protect against identity theft, only provide personal information to doctors, health care providers, insurance company, or approved Medicare plans.

 

Medicare does not call or visit to get in touch with their customers. So if someone arrives on their behalf, be suspicious.

 

Safeguarding Your Identity

In each plan, Medicare explains how they use their customer’s information. Check their guidelines so that you can discern when something does not add up to their explanation, and do not give the information out. In the event that you do experience identity theft, contact the Federal Trade Commission right away.

 

Looking Out At Your Doctor’s Office

Along with predators seeking patient’s personal information, other schemes happen at the hospital and may even involve the physician or health provider. It is vital to keep records of each doctor’s visit, each test that was taken, each procedure, and any prescribed medication.

 

If in the hospital, make sure the bill has the correct discharge date and diagnosis. Some forms of fraud involve charging Medicare for services never rendered. Keeping a personal health care journal can help the patient and caregiver remain vigilant and aware. Personal health care journals are available online or at the doctor’s office to conveniently keep track and document each visit.

 

Save any information from Medicare and read it thoroughly. Medicare documents provide information about what they do and do not cover, so if there seems to be any discrepancy between what is covered and what is being paid, the documentation exists to refute inconsistencies.

 

It is important to keep an eye on personal medical records to detect any sign of fraud. By reviewing Medicare Summary Notices and the subsequent Part D Explanation of Benefits, any mistakes between the medical records and what the information states can be resolved.

 

Don’t hesitate to ask questions. Medicare accounts are open to customer questions 24 hours a day. It is the customer’s prerogative to be informed and to have their questions explained. 

 

Important Things to Avoid

For the patient’s safety, it is important not to let anyone review personal medical records unless they are the patient’s doctor or a Medicare provider.

 

Do not visit a doctor for unnecessary treatment. Additionally, do not be persuaded by anyone to see a doctor for an unnecessary reason.

 

Again, Medicare does not send salesman to sell their services. If a salesman comes to the door claiming to be a Medicare representative, do not purchase anything they offer.

 

Do not listen to information that contradicts your health care provider. Many other sources are skewed and may not have pure motives.

 

While these tips may seem extensive, the importance of maintaining personal security within Medicare is a top priority. Remember, the patient’s wellbeing should always come first. If something seems fraudulent, report it. And do not be afraid to ask questions to help maintain personal security.

 

Image from www.bohemianbowmans.com

 

Author Jessica Socheski is a freelance writer currently researching healthcare plans from MDVIP direct primary care. You can find her on Twitter.

Post By Jessica Socheski (1 Posts)

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