TMH Living Well: Doing your part to deep Medicare costs down
September 11, 2015
For the greater good, Medicare representatives are urging its recipients to be astute with their Medicare transactions. Medicare fraud is a big industry and the more everyday people help watch for it, the better the Medicare program will run. Less fraud equals lower overall costs and better access to care. It's a win-win.
What can you do to help? Check your bills and report errors. Be judicious with your Medicare number and only give it when warranted. Know how to prevent identity theft. In a nutshell, stay aware.
"Up to 10 percent of Medicare payments are in the fraud or abuse category. Fraud is low, but growing, and becoming a concern," said Dan Blyth, operations manager for Colorado's Senior Health Insurance Assistance Program (SHIP) and the SMP Medicare Fraud Program.
According to a recent article in The Sentinel, in 2012 three to 10 percent of healthcare expenditures were lost to fraud, or an estimated $17 billion to $57 billion.
Check your bills
The Medicare.gov website offers tips to prevent fraud. When it comes to your bills, they advise using a calendar to record your doctor's appointments and what tests you've received. Then, check these against your Medicare statements. When spending time in the hospital, make sure the admission and discharge dates are accurate, along with the diagnosis.
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"Errors happen, particularly in large healthcare systems. It's often a mistake with billing, but sometimes it is deliberate fraud so we advise people to pay attention to their bills," Blyth said.
Be careful with your Medicare number
Medicare.gov advises that you treat your Medicare card like it's a credit card. It's that important. Don't give your Medicare card or number to anyone except your doctor or an authorized Medicare provider.
If someone knocks on your door selling medical supplies and says they are from Medicare, remember, Medicare does not send representatives to your home.
"We know of examples where people are getting phone calls from fraudulent parties with the caller saying there was some unusual Medicare activity on your account and they need to confirm your number. Or they say that there is a new law that says you need to re-enroll and they ask for your number," Blyth said.
Once such scammers have your number, or it has been obtained via identity theft, they sell it to people who will use it illegally to gain medical services. Such fraudulent use might show up on your medical record and impede on you getting the care you need.
If you suspect fraud or find a suspicious error on your bill, you can report it to the Colorado Medicare Fraud Hotline at 1-800-MEDICARE or in Colorado at 1-800-503-5190 (English) or en Espanol sin cargo 1-888-665-9668.
You can also talk with your local SHIP representative. Betsy Packer is the Medicare Coordinator for Northwest Colorado Council of Governments.
An open enrollment period to make changes to Medicare drug plans (Part D) is coming up this fall and is scheduled for Oct. 15 to Dec. 7. Packer is holding informational sessions in Craig at Sunset Manor and the Bell Tower Building. She is also available for personal consults with people who have questions about Medicare or who would like to better understand Medicare fraud. You can reach Packer at 970-819-6401.
"There is a difference between error and fraud. If you have any questions, it's wise to investigate," Packer concluded.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.