The best way to handle Medicare fraud is to prevent it from happening in the first place. Protect your Medicare number and only share it with trusted healthcare providers. But what if something does happen? How do we know if our number has been compromised?
The only way to know if your Medicare number is being misused is by reading your Medicare Summary Notice (MSN) or your Explanation of Benefits (EOB). These statements are mailed every 1–3 months and summarize all the services and products charged to Medicare during that timeframe. You can also receive them electronically at www.Medicare.gov.
You’ll find this information on Page 3 – Your Claims. Review the date, provider, and location of the appointment. Then verify the description of the service or product. Consider using SMP’s free My Healthcare Tracker to log your medical visits and match them with your MSN or EOB.
On Page 3, look for the “Claim Approved” section. If your claim was not approved, you have the right to appeal. You have 120 days to file an appeal. Page 4 of the MSN has detailed instructions on how and where to submit your written appeal.
Note: The Medicare Summary Notice is not a bill. It only shows what Medicare covered and the remaining balance. If you have questions about billing, contact your provider directly.
Mahalo to SMP Texas for contributions during this special Medicare Fraud Prevention Week awareness initiative.
This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $320,449 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS or the U.S. Government.
