If you detect or suspect fraud or abuse, you can do something about it, you can report it! Reported information is sent on to the appropriate authorities for further investigation. The information reported can collectively discern and expose a pattern of fraud or abuse. The authorities can then determine a course of action. All reports count – every report matters. Here are steps SMPs recommend beneficiaries take to report their concerns:
- Call the health care provider or supplier first to question the charge. If it was a mistake, ask them to correct it.
- Call the company that paid the bill if the provider or supplier can’t answer the question. Their contact information can be found on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB).
- Contact the Wisconsin SMP if you are not satisfied with the response you get from a provider, supplier, or billing company. Please have your MSN or EOB available when you call, along with any other supporting documentation that shows possible fraud or abuse.
- If fraud or abuse is suspected, SMPs refer cases to the proper authorities for further investigation.