Jul 28th, 2013 | By | Category: Senior Finances

Senior Medicare Patrol Explained

Many groups that support the needs of senior citizens express concern about waste and fraud in their support systems. Medicare and Social Security are just two of the ‘support system’ examples. There are many, including health care, and it is on the rise.

The Senior Medicare Patrol is a group of volunteers who do a good job of teaching seniors how to be on the alert for potential waste and fraud. In particular, these seniors and professionals teach other senior citizens how to protect their identity, how to read their Medicare summary notices and how to avoid falling for scams.

Identity Protection

Identity protection keeps a senior’s social security number and Medicare information in the hands of the beneficiary, and not in a place where it can be stolen. In this part of the program, seniors learn how to avoid making their SSN available to people who would use it fraudulently. The way we seniors can best protect our identity is to avoid giving our Social Security and Medicare information to anyone other than professionals who require it in order to provide service to us.

Medicare Summary Notices

The Centers for Medicare/Medicaid Services (CMS) send Medicare Summary Notices for every health-related service provided to a senior. Those summary notices identify the service provided, date, provider, and other more technical information related to coding the service. We all need to be reading those notices. And if we are caregivers for other seniors, we need to be reviewing them as well.

This writer had responsibility for caregiving for an elderly woman who resided in a nursing home. She received numerous services, and they were all billed to Medicare. I reviewed each Medicare Summary Notice carefully, and questions several of them over the six years of the patient’s residency in the nursing home. One, in fact, was fraudulent; I questioned it and did not receive a satisfactory response; I wrote the fraud notification address on the Summary Notice, and that provider was subsequently banned from providing Medicare services. The system works.

Be sure you review these notices for accuracy, and if you find something that you question, call your provider and ask about it. Medical providers cannot legally bill Medicare for any services they do not provide.

Here is the information for reporting suspected fraud:

By Phone: 1-800-HHS-TIPS (1-800-447-8477)
By Fax: 1-800-223-2164
(no more than 10 pages please)
By E-Mail:
By Mail: Office of the Inspector General
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026

Avoid Falling for Scams

Much has been written to advise seniors about scams. Our age group is highly vulnerable to scams and some of us are easily taken advantage of because we were taught to be very trusting as children. We’ve never stopped that behavior. We all need to learn about scams aimed at seniors, and we need to learn how to protect ourselves. The Internet provides excellent information about senior scams, and SCJ encourages you to do a search in your favorite search engine on a regular basis to update yourself about current scams against seniors.

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  1. […] As SCJ has said previously, the new ACA also takes a big swing at waste and fraud. A big part of reducing health care costs must occur in stopping the waste that we see in health care delivery. […]

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