Tips to help avoid health care fraud and abuse
How to help protect yourself and your family
There are a number of ways to avoid potential health care fraud and abuse schemes. Review these tips and learn steps you can take to protect yourself and your family.
- Callers or solicitors identifying themselves as any of the following:
“Health care representative”
“Health insurance counselor”
- Callers or solicitors identifying themselves as “Medicare”
Tip: Medicare does not make unsolicited phone calls. The best way to avoid unwanted calls is to register your number on the federal “Do Not Call” list. You can do this by calling 1-888-382-1222 from the phone number you wish to register or online at www.donotcall.gov
- Robocalls – prompting you to press any key to be connected to an agent
- Medical discount plans masquerading as health insurance
- Door to door solicitors or solicitors at public events
Tip: Watch out for DNA scams, in which scammers may approach you offering cheek swabs for genetic testing.
- TV commercials advertising “free” health care items
- Solicitors or ads offering gift cards, phones, etc.
- Health care professionals coming to your home without requesting or scheduling an appointment
Here are some ways you can practice caution over the phone.
- Use caller ID and avoid answering calls from unknown numbers
- If you do take a call, ask them who they are, why they are calling, and where they are calling from
- Be polite, but firm with responses like:
Please put me on the “Do Not Call” list
I am not interested, thank you
- Do not provide them with any personal information
- If being polite fails, you can hang up the phone
- Contact your phone carrier to block robo/telemarketing calls
- Be particularly vigilant. Telemarketers often target Medicare and Medicaid recipients.
When you’re viewing or managing information online, it’s important to take these steps.
- After viewing personal health or financial information on a website, log off the site or shut down your browser
- Never access personal health or financial information on a public Wi-Fi network, such as at a coffee shop or public library, or on a public computer
- Use a unique username and password for each of your accounts
- Do not use the same password for multiple accounts
- Update your password regularly
- Keep security patches and anti-virus software up-to-date on your personal computer
- Do not click on advertisement pop-ups
- Do a search for the latest scams (some will specifically target the elderly). Be informed, and be cautious.
Following these recommendations may help you keep your personal information more secure.
- Treat your insurance card as you would a credit card
- Never provide personal information, such as your health plan ID number, credit or debit card number (or other personal information) on a phone call you did not initiate
- Do not send debit card information or other personal information via email
- Choose a PIN number that does not appear in your wallet (for example, do not use your birthdate or your phone number)
- Shred financial documents before discarding
- Monitor your financial accounts regularly
- Do not let anyone except your physician’s office or pharmacy handle your Medicare/Member ID card. If anyone else requests your personal information, do not provide it.
- Never accept “free” medical equipment or services in exchange for your Medicare/Member ID number
Be on the lookout for these types of suspicious inaccuracies in health information and records.
- Office or telehealth visits that did not occur
- Health services you never received
- Billing from providers you do not know
- Billing for a more extensive service than what was provided
- Duplicate billing for identical services
- Dates of service that differ from your records
- Billing for supplies and/or devices you didn’t order or receive
- Billing for supplies and/or devices that you were told would be free or no cost
- If you notice any discrepancies, notify your insurance carrier immediately