1. Protect
2. Detect
3. Report
Detect
Learn to detect potential errors, fraud, and abuse.
Even when you do everything right, there is a chance that you could
be a target of health care fraud. There are a lot of ways that your
personal information can be used without your permission.
Here are some steps you can take to detect potential errors, fraud,
and abuse:
- Always review your Medicare Summary Notice (MSN) and Part D
Explanation of Benefits (EOB) for mistakes. Access to your current
Medicare account is available 24 hours a day. Simply visit www.MyMedicare.gov.
- Keep records of your health care visits, services and equipment
provided, significant lab results, etc. The SMP personal
health care journal or a pocket calendar is a good place to make
notes.
- Keep and file copies of any bills or notices from insurance
companies, doctors, hospitals, pharmacies, etc., as well as cancelled
checks.
- Compare your MSN and EOB to your personal
health care journal and prescription drug receipts to make sure they
are correct.
- Look for three things on your billing statement:
- Charges for something you didn’t get
- Billing for the same thing twice
- Services that were not ordered by your doctor
- Ask questions – ask your provider or plan*:
- WHEN…you don’t understand the charges billed
- WHEN…you don’t think you received the service
- WHEN…you feel the service was unnecessary
*If your provider or plan do not help you, contact your local
SMP.