How Can I Protect Myself From Medicare Fraud?



Medicare fraud is common in the health industry. Medicare fights these cases to the tune of billions each year. It affects patients just as well as Medicare, in terms of premium increases and option flexibilities decreasing. As a patient, there are certain things that need to be looked out for.

Scrupulous Services Means Buyer Beware

Many insurance agencies reimburse routine medical supplies and equipment when it is necessary. However there are times when companies push the minimum to get paid for it. Take for example home glucose testing strips. Blood glucose testing strips are quite common for seniors; however without adequate documentation to prove their use, they should not be reimbursed. Yet some Medicare fraud perpetrators push documentation anyway. As a result, more than four out five claims have resulted in fraud, or some documentation error, in cases related to the glucose testing strip. Other businesses have pushed known defective equipment in order to get paid.

Hospitals Are Guilty As Well

Medicare fraud even extends to medical organizations that bill patients for services. Some hospitals have taken advantage of Medicare by utilizing medical codes incorrectly. Medical codes are used by hospitals to bill for certain services; in fraud cases, they are used to claim a higher bill for an otherwise cheaper service. They have gotten away with it to a degree, because the codes will seem legitimate to the patients need. It is usually only caught during a thorough audit. Medicare fraud as a result is not limited in scope.

Solutions to False Documentation

False documentation is the most common crimes against Medicare to date. In order to curtail this, it is important to ask questions about your paperwork. It also helps to do business with reputed companies. Additionally, bills and invoices are typically formal, it is legal to request them when there is something suspect.



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