April 2017 Fraud Prevention Fact
The Missouri SMP wants you to be a wise consumer when it comes to your everyday health care. That probably means avoiding health screenings offered by strangers in malls, church basements or trailer offices.
For example, Medicare pays for an Annual Wellness Visit every year. The visit includes a health risk assessment based on medical history, risk factors for depression, functional ability, falls risk, and cognitive function. These health issues are best discussed with your own personal physician.
The Senior Medicare Patrol has received reports that companies are using aggressive phone calls and flyers to advertise services available for a short time in a temporary location. They say they offer prevention screenings, and often offer additional tests, which have out-of-pocket costs. When the beneficiaries go to the temporary clinic, they are asked for their Medicare information. Without the beneficiaries’ knowledge, the clinic bills Medicare for the Annual Wellness Visit. When the beneficiary goes to his own doctor for that Wellness Visit, Medicare denies the claim because the mobile clinic has already charged for it. Medicare will pay for only one each year.
If you need a screening, always call your doctor first. Always be wary of health providers that offer free screenings and ask for your Medicare number and insurance information. Don’t give your Medicare or insurance information for a free service. You could wind up with expensive bills or tests you don’t need. And, if Medicare pays for something you don’t need, it may not pay later for services that you really do need.
If you suspect Medicare fraud or abuse, call the Missouri Senior Medicare Patrol at (888) 515-6565. SMPs are funded through the U.S. Department of Health and Human Services, Administration for Community Living, Administration on Aging.