AARP Cyber-Tools Help Spot Medicare Errors, Fight Fraud

HARTFORD — AARP recently announced two new online tools to help Connecticut’s more than 562,000 Medicare members — and their loved ones — better understand their quarterly Medicare Summary Notices, which list the medical services and supplies billed to Medicare for their care.

Health care fraud costs Americans billions of dollars each year, but a careful reading of each Medicare Summary Notice can help consumers and their families fight back by spotting and reporting problems early.

AARP’s new Medicare Summary Notice “decoders” provide visitors with an easy-to-use, interactive sample notice.

Clicking on each section of the page displays details to help users understand their Medicare statement and out-of-pocket health expenses, and potentially spot suspicious charges. AARP has created decoders for both Medicare hospital insurance (Part A) and medical insurance (Part B) notices.

AARP Connecticut State Director Brenda Kelley said, “With health care costs already rising, people in Medicare and their families need every tool available to understand the services they pay for and crack down on the fraud and errors that cost them billions of dollars each year. Seniors and their loved ones can be a first line of defense by reviewing their Medicare Summary Notices every time and reporting problems to their providers or to Medicare.”

Medicare Summary Notices are mailed four times each year to anyone in Medicare who received services or supplies during the previous quarter. Each notice shows all of the charges to Medicare for the patient, as well as dates, descriptions, and billing codes.

AARP encourages seniors and their caregivers to review their notices regularly and follow these important tips to spot and report errors or fraud:

*Compare your bills. Do the dates, billing codes, and the service descriptions on your Medicare Summary Notice match the statements and invoices from your doctor and other health care providers? In some instances, your notice may include valid charges for services or supplies you were not aware you received — such as for medical consultations or tests. But, as a general rule, the dates and codes should match. If you do not see codes or other needed details on your provider’s paperwork, ask for copies that include that information.

*Contact your provider. If you see an entry for services or supplies you believe you did not receive, contact the doctor or supplier listed. It may be a simple mistake that can be easily corrected. If it is, the corrected entry should appear on your next Medicare Summary Notice. If there is an entry for services or supplies that Medicare did not cover, but you believe is a covered service, call your medical provider’s office to make sure the claim was submitted correctly. If it was not, ask the office to resubmit it.

*Contact Medicare. If you still have questions about your Medicare Summary Notice, or there is something you and your health care provider cannot resolve, call 800-MEDICARE (800-633-4227).

*Appeal a claim. If Medicare has not paid a claim you think it should have, you have the right to appeal. AARP’s decoders link to more information about appealing a claim.

Ms Kelley added, “We can all improve the health care we receive and save money by being engaged patients, asking questions and pointing out mistakes. If you or someone you know is in Medicare, be proactive and protect yourself and your loved ones.”

AARP’s Medicare Summary Notice decoders are part of a suite of tools to help people navigate the health care system and save money on their care. AARP’s health tools can be found at www.aarp.org/healthtools.