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Prevent Medicare Fraud — Become an Informed Medicare Consumer

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Have you ever become a victim of Medicare Fraud or are concerned that you might become one? Here’s everything you need to know about Medicare fraud and how to prevent it. 

Every year, the Medicare program loses thousands of dollars as a result of misleading practices. Medicare fraud harms both an individual who receives Medicare benefits and the program as a whole. The following guide explains how Medicare fraud occurs, how it impacts you as a beneficiary, and how you can prevent it from happening.

What is Medicare Fraud?

Medicare fraud takes place when someone intentionally defrauds the Medicare system to get a higher payment than what they are actually entitled to or receive an amount that they should not. Here are some examples of Medicare fraud:

  • When someone wrongly bills Medicare for items you never received or for supplies and services different from what you received. 
  • When you visit a specific medical clinic or physician, they ask you for your Medicare card and tell you the amount you owe them, but then they bill you for a larger amount and keep the difference in their pockets.
  • A fraudulent person uses someone else’s Medicare card to purchase equipment or receive medical services. Or they may return home medical equipment while continuing to bill Medicare for it.

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How to Detect Medical Fraud?

If you keep an eye out for unusual or suspicious activity, you can easily detect Medicare fraud. Watch out for providers who offer free services when you’ve already provided them with your Medicare card. Additionally, be cautious of providers who promise to cancel your co-payment for services without verifying if there’s an improvement in your financial situation or not.

Other warning signs to look out for include:

  • Receiving Medicare bills for services you did not receive.
  • Extra charges for co-payment on services that are meant to be 100% covered by Medicare.
  • Pressure selling for higher-priced services.
  • Marketing tactics like telemarketing used by providers. 
  • So-called free consultations for Medicare patients.  

Do Not Make False Accusations

If you accuse a provider of Medicare fraud, make sure it is not a mistake by double-checking with the provider first. Since computer and human errors often take place, it is vital to give your medicare amdvantage provider a chance to prove themselves. If the same mistake keeps repeating, you must thoroughly look into it. Falsely accusing your healthcare provider or physician is the last thing you would want to do. Hence, make sure to proceed with caution if you suspect any Medicare fraud. 

Furthermore, when you decide to report a fraud, be certain to gather all the facts. You will require every little detail about the provider, like their address, name, type of practice, phone number, and more. Additionally, you might have to collect other data to present your case clearly. You must put together in writing a brief timeline of events that occurred, including the date, wrongly billed services or items, and other relevant information.

Take Preventive Measures

If you believe that you or your close ones have become victims of Medicare fraud, get in touch with your state or local Medicare officials and report the issue to them. You can also take the measures below to help prevent Medicare fraud:

  • Watch out for those who want to look over your medical records when they are not offering medical services to you. 
  • Never reveal your Medicare card number or give your Medicare card to someone who isn’t a physician or caregiver.
  • Never demand medical services that you do not require. 
  • Beware of free medical services or consultations being offered by a physician or caregiver. 
  • Be cautious of providers who claim to be able to get Medicare to pay for products or services that Medicare does not cover.

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All in all, it’s crucial to trust your instincts. If something doesn’t feel right,  look into it and figure out what’s going on. Being alert and taking precautions during any medical situation can protect you and your loved ones from Medicare fraud. 

Always remember, most criminals do not hide their identities under masks and appear in black clothing. Medicare fraudsters may pass themselves off as regular caregivers or doctors, so be cautious when giving out personal details like your Medicare card.

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