4 Effective Tips for Avoiding Medicare Fraud

4 Effective Tips for Avoiding Medicare Fraud

Medicare fraud usually involves either a patient who knowingly deceives Medicare to receive benefits or when a healthcare provider overcharges Medicare. Identity theft of a patient can lead to fraud as well. Here are a few important tips for avoiding Medicare fraud.

  1. Identify Medicare Fraud

    Don’t allow yourself to get entangled in a web of Medicare fraud, which may not seem obvious at first. Many fraud cases have unfolded over the past few decades involving hospitals overcharging Medicare for services that were never rendered. Many healthcare organizations have gotten away with it when seniors don’t review all the details of their bills.

    Your physician is not supposed to charge you for most preventative services. Make sure the hospital isn’t running up a list of tests that never happened. This technique has been common in Medicare fraud cases. If you see such erroneous charges, notify the billing department. Notify Medicare if your hospital doesn’t respond or address the issue.

  2. Secure Your Medical Information

    Another way Medicare fraud can occur is when someone steals your medical information. A thief can use it to impersonate you and get healthcare services or cash. Make sure you only allow medical professionals to access your medical records. Hospitals must follow federal privacy regulations established by HIPAA.

  3. Protect Your Medicare Number

    Your Medicare number should be as secret as any of your banking information. Only share your medical history with your doctor or other medical professionals. Be suspicious if anyone besides a healthcare practitioner asks for this information. Don’t fall for the scam of giving up your number to a con artist who says they’ll offer something free in return.

  4. Be Aware of Medicare Marketing Rules

    Insurance companies are bound by rules designed to discourage marketing fraud. Less reputable firms might try to exploit seniors who ignore policy details. Make sure you understand a policy’s rules and benefits before signing up. Here are some of the rules insurance companies that promote Medicare Advantage must follow:

    • Federal and state telemarketing laws
    • Cannot call a sales prospect without first getting permission from them
    • May not visit the patient’s home without being invited
    • Must not cross-promote different insurance products in one appointment
    • Not allowed to contact patients on behalf of Medicare

Additionally, healthcare organizations cannot engage in bribery or receive kickbacks from other entities to prescribe or promote certain medical products. Ultimately, committing Medicare fraud is cheating the government, which can lead to criminal charges, fines, and jail time.

Medicare frauds usually result in higher medical costs and taxes for everyone. Therefore, it’s important to make sure all your communication with Medicare is accurate and honest. Contact us here at Medicare Advisors for answers to your questions about Medicare.