Learn how to detect errors & fraud.
Prevention alone cannot stop all fraud, abuse, and errors. We should also be aware and watchful of inaccuracies and needless waste in our health care system. As health care consumers we are in the best position to notice any inaccuracies. By detecting potential problems, we can help reduce the amount of money lost to waste, abuse and errors, a reduction that benefits all of us.
Keep records of health care visits, services or equipment received, test results, etc. The Wisconsin Senior Medicare Patrol provides a My Health Care Tracker as a tool to help keep information all in one place.
Guidelines for using your My Health Care Tracker ask yourself these questions before your health care appointment:
- What are my symptoms? When did they start? What makes them better or worse?
- What over the counter or prescription medications am I taking?
- Is this appointment going to be covered by Medicare or my other insurance?
- Write down the answers to these questions
- Bring your tracker to all your appointments.
- Note in this journal what happens during your visit (i.e. lab work, x-rays, other tests)
- Write down any additional steps needed or further appointments
- Make sure that you understand what your health care provider is telling you before you leave the appointment. If you don’t understand, ask them to explain the information in a different way so that you understand.
- Use this journal to compare your Medicare Summary Notices (MSNs) or Explanation of Benefits (EOBs) to make sure that all claims filed are accurate.
Save copies of bills received from your doctor, hospital, pharmacist, supplier, or other health care provider.
When you receive your Medicare Summary Notices (MSNs) and Explanations of Benefits (EOBs) open and review them to make sure everything is correct. Here are some things to look for:
- Compare the dates, providers, and services received, shown on MSNs and EOBs, to what is documented in your personal health care records or health care tracker.
- Beware of charges for services not received, duplicate charges, or services that were not ordered by your doctor.
Do You Have Questions or Concerns? Call and Ask.
Ask questions of your provider, 1-800-MEDICARE, or your other health care insurance when:
- You don’t understand the charges billed.
- You don’t think you received the service.
- You feel the service was unnecessary.
- You were charged for the same thing twice.