Medicare Fraud Tips

You should be suspicious if the provider tells you that:

  • The test is free; he only needs your Medicare number for his records.
  • Medicare wants you to have the item or service.
  • They know how to get Medicare to pay for it.
  • The more tests they provide the cheaper they are.
  • The equipment or service is free; it won't cost you anything.

Be suspicious of providers that:

  • Routinely waive copayments without checking on your ability to pay.
  • Advertise "free" consultations to Medicare beneficiaries.
  • Claim they represent Medicare.
  • Use pressure or scare tactics to sell you high priced medical services or diagnostic tests.
  • Bill Medicare for services you do not recall receiving.
  • Use telemarketing and door-to-door selling as marketing tools.

Be suspicious of:

  • Home health providers that offer non-medical transportation services or housekeeping as Medicare approved services.
  • Physicians who bill Medicare for telephone calls, conferences with the family, or scheduled but not kept appointments.
  • Physicians who bill Medicare for routine check-up.
  • Ambulance companies that bill Medicare for routine trips to a doctor's office.
  • Physicians that give the wrong diagnosis on the claim form so Medicare will pay.
  • Ambulance companies that bill for trips which are not emergency in nature.
  • Home health providers that bill for patients who are not confined to their home.
  • Home health providers bill for Medicare patients who still drive an automobile.
  • Suppliers that bill Medicare for medical equipment for beneficiaries in nursing home.
  • Hospital providers that bill Medicare for tests you received as an inpatient or within 72 hours of admission or discharge.
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