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Protect Yourself and Medicare from Billing Fraud

 Most doctors, health care providers, plans, and pharmacies who work with Medicare are honest. There are a few who are dishonest. Medicare is working with other government agencies to protect you and the Medicare Program from such dishonesty.

Medicare fraud happens when Medicare is billed for services you never got. Medicare fraud takes a lot of money every year from the Medicare Program. You pay for it with higher Premiums. A fraud scheme can be carried out by individuals, companies, or groups of individuals.

If you suspect Medicare billing fraud
If you suspect billing fraud, you can call
  1. your health care provider to be sure the billing is correct, or
  2. 1-800-MEDICARE (1-800-633-4227; TTY users should call 1-877-486-2048), or
  3. the Inspector General's hotline 1-800-HHS-TIPS (1-800-447-8477).
When you get health care in the Original Medicare Plan, you get a Medicare Summary Notice from a company that handles bills for Medicare. It shows what services or supplies were charged and how much Medicare paid. Check the notice for mistakes, and make sure that Medicare wasn't charged for any services or supplies that you didn't get. If you see a charge on your bill that may be wrong, call the health care provider, and ask about it. The bill may be correct, and the person you speak to may help you to better understand the services or supplies you got. Or, you may have discovered an error in billing that needs to be corrected. If you aren't satisfied after speaking with your provider, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

(Primary Source: Centers for Medicare and Medicaid Services - Medicare and You Handbook. This content may have been enhanced by Q1Group LLC to include further examples, explanations, and links.)


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