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Senior Medicare Patrol Medicare Fraud and Abuse
Did you know that Medicare loses approximately 60 billion dollars each year to improper claims. Whether done intentionally or in error, Medicare fraud and abuse also affects YOU. You could be a victim of fraud and not even know it. False information can end up on your medical records, leading to improper medical care later. You may even be denied services you need and deserve.
Medicare Fraud occurs when a person or company knowingly tricks Medicare. They intentionally bill Medicare to receive payment they are not entitled to. Medicare Abuse occurs when providers seek Medicare payment they don’t deserve but have not intentionally done so. Abuse can also involve billing for unsound medical practices.
Some Examples of Fraud and Abuse
- Billing for services, supplies, or equipment that were not provided to you.
- Calling Medicare beneficiaries and asking for your Medicare number, claiming it is needed to obtain a new Medicare card or keep your Medicare benefits.
- Attempting to obtain your Medicare number in exchange for “free” services.
- Billing for services that are different than what you were provided.
- Billing for services or supplies that are not medically necessary (to get a higher payment).
- Billing for excessive medical services and supplies.
How Your Senior Medicare Patrol (SMP) Can Help Your local SMP is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, error, and abuse, DETECT potential fraud, error, and abuse, and REPORT your concerns. SMPs use trained senior volunteers to help educate and empower fellow seniors in the fight against healthcare fraud. Your SMP can also assist you with your questions, concerns, or complaints about potential fraud and abuse you observe. It provides information and educational presentations, too. To contact your local SHINE Senior Medicare Patrol Program:
Visit www.floridashine.org or call the Elder Helpline 866-467-4624 SHINE provides free and unbiased health insurance counseling through a network of volunteers, empowering Florida seniors to make informed health choices. Cost savings could be yours too through the Medicare Savings Programs and the Extra Help Program.
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