Medicare Fraud

This information is provided via the Area Agency on Aging Region One located in Maricopa County.  Call the 24-hour Senior HELP Line for more 602.264.4357 or 1.888.264.2258.

Every 3 months, a Medicare summary notice is mailed to you.  It is not a bill.  It is a list of the claims billed to Medicare on your account.

Look for any possible mistakes:

The Medicare Number.  Are the last four digits yours?
The Date.  Did you have a medical service that day? Note: a test might have been done on a different day than when you had it.
The type of Service.  Is this what you had done?
The Provider Name.  Is this who provided the service or medical supply? May have a different name if seen by a specialist or what you call the doctor or hospital.
The Address.  Is this where you received the service?  The address shown will be where the bill comes from.

Call your doctor, hospital, or supplier right away if you have questions.  Ask them to explain payments.

How can mistakes happen?  Your Medicare claim is submitted twice or the wrong code is entered, indicating you had a more expensive test.

How can "fraud" happen?  A criminal uses your Medicare number to file fake Medicare claims.  If your wallet or mail is stolen or if someone phones or visits you pretending to be from Medicare and you give them your Medicare number.

A dishonest health care provider bills Medicare for more services than you received.

What you can do.

Understand what Medicare covers, read your Medicare Summary Notice or ask Area Agency on Aging to send you a SMP (Senior Medicare Patrol) Personal Health Care Journal to write down all your medical visits.  Compare that to your Medicare Summary Notice or Explanation of Benefits.

Only give your Medicare number to trusted sources.  Guard it like your Social Security, credit card and bank account numbers.  Do not carry in your wallet.

Please take care of yourself and your identity.