If you believe Medicare is being ripped-off, call or write the Medicare company that paid the claim. The name, address, and telephone number are on the Medicare explanation of benefits which shows what Medicare paid.
Before contacting the Medicare claims processing company, carefully review the facts as you know them and as shown on explanation of benefits. Write down:
1. The provider's name and any identifying number you may have.
2. The item or service you are questioning.
3. The date on which the item or service was supposedly furnished.
4. The amount approved and paid by Medicare.
5. The date of the explanation of benefits.
6. The name and Medicare number of the person who supposedly received the item or service.
7. The reason you believe Medicare should not have paid.
8. Any other information you may have showing that the claim for the item or service should not have been paid by Medicare.
If you plan to write rather than call, clearly state at the beginning of your letter that you are filing a fraud complaint. This will help to ensure that your complaint is forwarded to the fraud unit.
Coming soon: A listing of fraud unit addresses.
Office of Inspector Hotline
If you prefer you may call the O IG Hotline at 1-800-HHS-TIPS (1-800-447-8477).Last Updated Febrauary 23, 1998