Medicare Claim Fraud

[flytire 0]

On Monday I received a Medicare insurance card in the mail with a letter stating that Medicare found fraud using my cards number

I called Medicare to verify and all they told me was that fraud had occurred and thats why I was sent a new card

So I then decided to go to the Medicare.gov website to do a little more investigation.

Once there I found all of my claims dating back to 2021. Lo and behold, I found 13 claims that were not even mine

One claim was for over $7700 for catheter supplies from a doctor in Brooklyn, New York. Ive never been to Brooklyn in my life

Most of the other claims were for $96 and Covid test kits and from locations I have never been to. The Medicare agent I talked to verified that these claims were not from the free USPS test kits

It took me about an hour on the phone with the agent to go through all of the fraud claims. Hopefully these fraud claims will be sent to their fraud division and recover the amount Medicare paid these fraudsters

So if you are on Medicare or even other insurances, check your monthly statements regularly for fraudulent claims.

[SalarMan 0]

Thanks for this one Norm!!  I'm on a Medicare Advantage plan and I check my statements as they arrive, and I do so in detail.

Great advice about going over your statements carefully!!

[flytire 0]

i just found the same $7700 claim on my United Healthcare supplemental insurance plan

that doctor was scamming everybody

Called United Healthcare and they have it flagged as fraud 👍👍

[SalarMan 0]

I hope they prosecute and send a son-of-a-bitch like that to the joint for a LONG time!!

[mikechell 0]

I turn 65 in July.  I'll keep this info in mind as I make the transition.

Thank you.

[niveker 0]

Sux. 

Amazing that this goes unnoticed for so long, but I forget to include a 1099 of $600.01 on my taxes and 8 days later I got an IRS agent knocking on my door with a proctoscope. 

[SalarMan 0]

14 hours ago, mikechell said:

I turn 65 in July.  I'll keep this info in mind as I make the transition.

Thank you.

I am a little older than you (75), and if memory serves me well you will receive preliminary paperwork and info a month or 2 in advance...so be prepared.

I'll add that thanks to Norm I went to my Medicare advantage plan this morning to check things out and all is fine. I will continue to do that sort of thing on a regular basis and I suggest to everyone to do that as well!!

Welcome to that certain age 😁👍😁

[flytire 0]

united healthcare removed the $7700 fraud i complained about from my claims page 👍👍

medicare hasnt done anything....yet

[vicrider 0]

I have been very careless about checking for fraud I'm afraid. When I open the envelope and it says "This is not a bill" I usually toss it instead of checking it out. With the entire Social Security and Medicare programs constantly running short of money that should be there I'm sure that much of that is because of fraud like you experienced. I will begin checking my charges from now on and if there is fraud I will report it promptly. Thanks for bringing this up. I knew fraud in Medicare was rampant and costs us all money but never thought to try to do my part to combat it.

[flytire 0]

you can view all of your Medicare claims on medicare.gov website. just create an account 

same thing for whatever supplemental insurance you have

[jcozzz 0]

Had a fam member that did billing for some of these fraudsters.he was an accountant and just shuffled paper so was not involoved in the actual fraud tho. But was in charge of billing for these medical vendors. He was key witness FOR the feds tho.Turned his quiet life upside down for some time.There was even a homicide and fugitive search involved.Can't make this stuff up.Once it was over and he could talk about it was like crime novel.We sat up all night by a fire on fishing trip years ago  listening to his story.People will do crazy things for a few bucks or a lot of bucks i guess.

[Poopdeck 0]

17 hours ago, jcozzz said:

Had a fam member that did billing for some of these fraudsters.he was an accountant and just shuffled paper so was not involoved in the actual fraud tho. But was in charge of billing for these medical vendors. He was key witness FOR the feds tho.Turned his quiet life upside down for some time.There was even a homicide and fugitive search involved.Can't make this stuff up.Once it was over and he could talk about it was like crime novel.We sat up all night by a fire on fishing trip years ago  listening to his story.People will do crazy things for a few bucks or a lot of bucks i guess.

Or a single buck or no bucks

[Trouttramp 0]

Some of those bills are almost undecipherable.  
I had a hospital stay of 7 days, three heart procedures, blood and urine tests plus doctor visits every day. A return visit for a stroke for two days with an MRI and CAT scan. 
That’s with three visits to the ER and one ambulance ride. 
The final hospital bill was in excess of 90k, over two dozen pages of line item charges, some I can’t even pronounce or understand.  
No one short of a medical accountant can understand those bills. 
When my wife and I turned 65, we bought the best supplemental coverage we could get. The bill to me was 258$

Most expensive bill we have is medications, even with the best scrip plan out there, we still pay 8-10k a year combined for meds, and we have shopped around for the best prices. Some meds do not get discounted no mater where you buy them.

There MUST be a better way. 

TT

[SilverCreek 0]

1 hour ago, Trouttramp said:

Some of those bills are almost undecipherable.  
I had a hospital stay of 7 days, three heart procedures, blood and urine tests plus doctor visits every day. A return visit for a stroke for two days with an MRI and CAT scan. 
That’s with three visits to the ER and one ambulance ride. 
The final hospital bill was in excess of 90k, over two dozen pages of line item charges, some I can’t even pronounce or understand.  
No one short of a medical accountant can understand those bills. 
When my wife and I turned 65, we bought the best supplemental coverage we could get. The bill to me was 258$

Most expensive bill we have is medications, even with the best scrip plan out there, we still pay 8-10k a year combined for meds, and we have shopped around for the best prices. Some meds do not get discounted no mater where you buy them.

There MUST be a better way. 

TT

Have you looked into getting drugs from overseas?

Drugs from companies in Canada are cheaper.

https://www.singlecare.com/blog/ordering-medications-from-canada/#: