Securing Your Finances: 5 Effective Strategies Against Medicare Fraud

Jan 26, 2024 By Susan Kelly

Medicare fraud is an internationally most talked about medical scam. Due to the recent outbreaks in the world economy and industry sectors, Medicare prescription fraud has become profitable. A CMS facility representative said the public health crisis has allowed scammers to edit and reuse schemes. Here, we have compiled the five most common strategies to defend yourself from any to every medicare breach.

Keeping Your Medicare Number Safe

It is extremely important to protect your Medicare number. An unauthorized individual could exploit it to commit identity theft or transmit fraudulent medical invoices. Consider your Medicare number to be on par with the confidentiality of your Social Security and credit card information. Share it only with reputable healthcare providers or official administrators of the Medicare authorities.

Be wary of unanticipated individuals who request your Medicare information. This may occur through telephone or when an individual visits your residence while posing as an employee of Medicare. Remember that Medicare will never unexpectedly dispatch a representative to your home. Additionally, Medicare agents will not request your phone number over the phone unless you have given prior consent.

Always avoid giving out Medicare information. The Federal Exchange Commission stated a 25% growth in identity robbery court cases, such as many regarding healthcare information, in 2021. Healthcare fraud costs the United States $68 billion annually, keeping with the national anti-Fraud affiliation. Protecting sensitive information like your Medicare number helps prevent identity theft. Ensure the person is who they say they are before giving Medicare information. Report suspicious activity to the police. You can fight healthcare fraud and protect your personal information by being vigilant.

Caution Against Complimentary Offers

It is prudent to approach dubious freebies with a reasonable degree of skepticism. Criminal investigator Isaac Bledsoe of the Health and Human Services Office of Inspector General (HHS-OIG) cautions against placing unwarranted confidence in seemingly enticing offers. Frequently, these offers serve as a pretense for con artists seeking to obtain sensitive financial or medical information. For example, one may encounter appealing promotions such as complimentary blood tests, genetic testing services, or medical equipment (e.g., walkers or braces). What is the catch? In exchange, you are frequently requested to provide sensitive information.

Approximately 25% of fraud incidents, according to a study by the Federal Trade Commission (FTC) in 2021, involved some form of gift or service inducement. Conspicuous increases in the prevalence of these prescription frauds have been documented in countries experiencing health crises.

Before taking advantage of such deals, be cautious and consult a trusted medical professional. You can fall for fraudsters' increasingly devious tricks if you're not careful. The Better Business Bureau reported that 'free' offer scams cost Americans $3.3 billion in 2022.

Beware of Unnecessary Medical Procedures

It is crucial to stay vigilant regarding the imposition of expenses for non-important clinical offerings within modern-day healthcare settings. In January 2022, the Healthcare Fraud Prevention Partnership posted a white paper. Members of this alliance, committed to combating healthcare fraud, are affiliated with the personal and public sectors.

Always verify information with a reputable healthcare professional. They can assist you in determining whether a specific medical service is essential and estimate the associated costs. This stage assumes particular significance in circumstances where the indispensability of a specific service is ambiguous.

Remember that trust in your healthcare provider and accurate information are essential when making healthcare decisions. It is highly advisable to inquire and seek clarification regarding any medical service, particularly if it entails substantial financial investment. By exercising prudence and knowledge, one can prevent avoidable medical expenditures and guarantee the receipt of essential medical treatment.

Reviewing Your Medicare Statements

Medicare will send you detailed healthcare expense statements regularly to avoid any mixups or ongoing scams. As responsible citizens, it is also your duty to check these claims carefully. Your medical bills, Medicare's share, and out-of-pocket costs are listed. Avoid unfamiliar charges.

One option to improve how you track your medical records is to invest in a "My Health Care Tracker." You can get this helpful resource at no cost from your state's Senior Medicare Patrol (SMP). With the help of government grants, the SMP is working to lessen medicare breaches and errors by disseminating useful information and recommendations.

The "My Health Care Tracker" program gives you dedicated pages to record information regarding your medical treatment. Also included are instructions for reconciling Medicare claims with the services rendered. Also included are contact details for organizations that can help with billing errors or possible fraud.

Major Medicare card scams must be addressed. Healthcare fraud and false claims cases netted the DOJ over $2.2 billion 2021. All Medicare bills must be accurate because millions of Americans depend on it. The fact that 64 million Americans were enrolled in Medicare by 2023 showed the impact of supervision. Health Care Tracker can help protect the healthcare system from fraud and ensure accurate billing if more people use it.

Seeking Assistance for Medicare Fraud

There are free resources to help you detect medicare card scams. Please report suspicious or fraudulent activity. You can call two main government hotlines for help. CMS representatives can be reached at 800-MEDICARE (800-633-4227) for Medicare assistance. Waste, fraud, and abuse complaints can be online at oig.hhs.gov/fraud/report-fraud or by calling 800-HHS-TIPS (800-447-8477). Another resource for information and advocacy is your neighborhood's Senior Medicare Patrol. Visit smpresource.org for their contact details.

You are not required to contact multiple agencies to report an issue. Efficient handling of reports is ensured through coordination between different agencies. Bledsoe claims that one central location is adequate for reporting and that the agencies can ascertain the gravity of the problem in a flash. They can also add your Medicare number to a watchlist to prevent fraudulent charges and provide future support.

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