Tips to Prevent Fraud and Abuse
- Always keep a record of your health care appointments, the services received and compare them to your Medicare Summary Notice, Explanation of Benefits and any billing statements received from health care your provider/s. Record your doctor’s visits, prescriptions, etc., in your personal healthcare journal which can be obtained by calling the MA SMP Program, 800-892-0890.
- Only your primary care physician (PCP), specialist, hospital and/or clinic that you frequent should make referrals for special equipment, other medical services or prescribe medicine.
- Never show anyone your medical or prescription records without first talking to your doctor or pharmacist.
- Never accept an offer of free medical equipment or supplies.
- Be suspicious and cautious of “free” offers that require your Medicare or Medicaid number.
- Never accept medical supplies or equipment from door-to-door salesman.
- If someone calls and tries to pressure you into purchasing something, making a donation or anything else—SIMPLY HANG UP THE PHONE.
- If someone comes to your door and says they are from Medicare or some other healthcare company, DO NOT LET THEM IN YOUR HOME and CALL YOUR LOCAL POLICE.
- Do your homework and talk to your healthcare provider before buying or investing in internet “cure-alls” or miracle products or services.
- Don’t keep mail in your mailbox for more than one day. Your personal information can be stolen right from your mailbox.
- Rip up, shred or otherwise destroy your Medicare or other healthcare papers and other important documents instead of just throwing them away. Scammers may go through your trash!
- Treat your Medicare and Social Security cards like credit cards. If someone offers to buy your Medicare or Social Security number, don’t do it! It is illegal!
- Remember this! Medicare doesn’t sell anything, Medicare doesn’t make home visits and Medicare will not give you anything.
- Follow your instincts—if it seems too good to be true, it probably is!
- Always read your Medicare Summary Notice (MSN) or health care billing statement (Explanation of Benefits). Your MSN & other Explanation of Benefits forms are generally stamped “THIS IS NOT A BILL” and come in after your receive medical care.
Look for three (3) things on your billing statement(s):
- Charges for something you didn’t receive
- Billing for the same thing twice
- Services that were not ordered by the Doctor.
- If you suspect any errors, fraud or abuse related to your healthcare, call the MA SMP Program office, 800-892-0890.
