At this month’s volunteer ombudsman training we learned that there is $60-90 billion (Billion, you got that right) of Medicare fraud in the U.S, of which less than $10 billion is ever recovered.
Aileen Fisher, of the Senior Medicare Patrol, (SMP) a volunteer whose mission is to protect seniors and their loved ones from health insurance scams presented her work to a rapt audience of potential investigators. Since Ombudsman Services volunteers are in facilities every month, we are encouraged to look for things that don’t seem right.
Is there billing for unnecessary, non-existent care or more expensive services?
- Is there a fraudulent diagnosis
- Is someone calling or asking for Medicare numbers
The SMP is set up to protect, detect and report.
How do I protect myself?
Treat your Medicare number like a social security or credit card. Never give the number to a stranger. Medicare doesn’t call or visit to sell you anything. Keep your own records of the healthcare you’ve received and compare it the Medicare Summary Notices. Sometimes you won’t even know someone is using your account until you get denied service. Don’t forget to shred documents when they are no longer useful.
Ombudsman Services volunteers were in encouraged to look for equipment that isn’t being used or multiple, identical wheel chairs, hospice or therapy services that aren’t needed. You can also check your billing statement for charges for something you didn’t get. Identity theft is a real problem that takes vigilance to conquer.
It’s important to report your concerns about fraud and abuse to protect other people from becoming victims and to help save Medicare benefits.
Call your local SMT at 1- 877-808-2468