Preventing Medicare Fraud: Tips, Types, and Reporting
Learn how to prevent Medicare fraud by educating yourself, being vigilant about false charges, understanding different types of fraud, and following dos and don'ts. Protect your personal information, read your Medicare Summary Notice, and report any suspicious activities to the relevant authorities.
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Presentation Transcript
What is healthcare fraud? False charges or false use of identity. Billing for services that were: Never provided Unnecessary Inflated cost
Types of Medicare fraud: Services never performed Supplies not ordered Returned equipment Unnecessary items/services False identity Double Billing Upcoding Unbundling Kickbacks
Prevention dos Protect your number Ask questions. Educate yourself. Record medical services. Review your Medicare summary. Report suspicious charges.
Prevention donts Don t allow everyone access to records. Don t request a service you don t need. Don t deal with door-to- door salesmen. Don t be influenced by advertising.
Protect, Detect, Report Protect Your personal information Medicare Number, Social Security Number, Bank Account Information Detect Fraud, errors and abuse by reading your Medicare Summary Notice (MSN) Report Fraud, errors and abuse to your Arkansas SMP 866-726-2916
How to Read Your Summary Notice Ask yourself these questions: Are there charges for any medical services or equipment that you didn t get? Are the dates of service accurate? Was Medicare billed for the same thing twice? Have you received any collection notices for medical services or equipment you didn t receive?
Who to Contact: Kathleen Pursell AR SMP Program Director 501-320-6457 Fraud Hotline 1-866-726-2916
Fraud & Scam Activity Identify the potential fraud or scam. Suggest ways the consumer could respond.
You can help prevent fraud! For presentations to your local group: Kathleen Pursell, AR SMP Program Director 501-320-6457
