Medicare fraud and medical identity theft can cost taxpayers billions of dollars each year. Medical identity theft is when someone steals or uses your personal information (like your name, Social Security Number, or Medicare Number) to submit fraudulent claims to Medicare and other health insurers without your permission.
Medicare is working to find and prevent fraud and abuse. We’re working more closely with health care providers and improving the way we review Medicare claims for possible billing fraud. Read the full article here to learn how you can help fight and protect yourself from fraud.
How to spot & report Medicare fraud
Protect yourself and Medicare against fraud by reviewing your Medicare claims for errors, looking for other types of fraud, and reporting anything suspicious to Medicare.
Review your Medicare claims for errors
When you get health care services, record the dates on a calendar and save the receipts and statements you get from providers to check for mistakes. Compare this information with the claims Medicare processed to make sure you or Medicare weren’t billed for services or items you didn’t get.
After Medicare processes your Original Medicare claims, you can review them by:
- Looking at your “Medicare Summary Notice.”
- Visiting MyMedicare.gov.
- Calling 1-800-MEDICARE (1-800-633-4227) and using the automated phone system. TTY users can call 1-877-486-2048.
“Medicare Summary Notice” (MSN)
If you have Original Medicare, check your MSN. This notice shows the health care services, supplies, or equipment you got, what you were charged, and how much Medicare paid. If you’re in a Medicare health plan, check the statements you get from your plan.
Review each notice you get to make sure that it’s accurate and that you and Medicare weren’t billed for services or items you didn’t get. If you see a charge that may be wrong, see page 8 to learn how to report it.
MyMedicare.gov
MyMedicare.gov is a free, secure online service that’s available to help you access your personal Medicare-related information 24 hours a day, every day.
You don’t have to wait for your “Medicare Summary Notice” to view your Medicare claims. You can visit MyMedicare.gov to track your Medicare claims or sign up for electronic “Medicare Summary Notices” (eMSNs).
1-800-MEDICARE
You may also get information about your Original Medicare claims that have been processed in the past 12 months through Medicare’s automated phone system. You don’t need to speak to a customer service representative. Just call 1-800-MEDICARE (1-800-633-4227) and provide a few key pieces of information. TTY users can call 1-877-486-2048.
It’s also helpful to understand what Medicare pays for. You can find this information in your “Medicare & You” handbook. If you don’t have a copy, visit Medicare.gov/medicare-and-you or call 1-800-MEDICARE.
Note: If you think a charge is incorrect and you know the provider, you can call his or her office to ask about the charge. Your provider or his or her staff may give you information that helps you better understand the services or supplies you got. Or, they may find an error that needs to be corrected. Correcting a billing error benefits both you and Medicare.