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Nevada Senior Medicare Patrol (SMP) educates Nevadans on how to protect, detect and report healthcare fraud in Medicare and Medicaid in order to protect these vital healthcare programs for the future.
Every year the Medicare system is drained of billions of dollars as a result of fraud, waste, errors and abuse.
The Nevada SMP is funded and supported by the U.S. Administration for Community Living and works closely with the Centers for Medicare and Medicaid Services.
There is an SMP in every state whose mission is to empower and assist Medicare beneficiaries, their families and caregivers to prevent, detect, and report health care fraud, errors and abuse through outreach, counselling, and education.
Examples of fraud and abuse can include, but are not limited to:
- Billing for services different than actually provided
- Providing and billing for unnecessary procedures or services
- Billing for a higher level of service than what was actually provided (i.e. billing the level allowed for a new patient when actually the beneficiary is an existing patient)
- Billing for services not received
- Billing non-covered services as covered services (i.e. billing routine nail care as foot surgery)
- Offers of "FREE" services and then billing Medicare
Medicare beneficiaries play a vital role in detecting these instances of fraud, errors, and abuse and reporting them to Nevada Senior Medicare Patrol.
Here are some ways to Prevent, Detect and Report Medicare fraud, errors and abuse:
PREVENT healthcare fraud by protecting your medical identity such as your Medicare number.
- Treat your Medicare card and number like you would a credit card. Medicare cards and numbers contain Social Security numbers, making them as valuable to thieves as a credit card.
- Only share your Medicare number with trusted sources such as health care providers.
- Medicare does not call you unless you have called them. Beware of scammers calling to “verify you Medicare number or bank account information.”
- Treat any offer of free services in exchange for your Medicare or healthcare identification number with caution. If it is free, it’s free.
- Rely on your doctors for medical advice and prescriptions. Don't be influenced by advertising for services, medications, or products.
DETECT potential errors, fraud, and abuse.
- Record your doctor's visits and prescription drugs in a Personal Healthcare Journal, which is available from the Nevada SMP program.
- Carefully review your quarterly Medicare Summary Notice (MSN) and/or your Explanation of Benefits (EOB) for mistakes. Or register on myMedicare.gov to view MSN's in real time. (Compare your MSN and EOB to your Personal Healthcare Journal.)
- Look for three things on your MSN or EOB:
- Charges for something you didn’t get
- Billings for the same service twice
- Services or products that were not ordered by your doctor
REPORT it if you suspect that you have been a target of errors, fraud or abuse.
- If you have questions about information on your MSN or EOB, call your provider or plan first.
- If you are not comfortable calling your provider or plan or you are not satisfied with the response you get, call Nevada Senior Medicare Patrol. TOLL-FREE Help Line (888-838-7305).
Our team of volunteers and staff provide outreach and education to citizens across our state in a number of ways.
- Conducting presentations for interested parties to educate them on the signs of fraud, waste and abuse.
- Staffing exhibits at health fairs, senior fairs and other community events.
- Providing one-on-one counselling sessions with Medicare beneficiaries, their family and caregivers to assist with suspicious billings.
- Networking with the other senior support agencies and non-profits in the state.
- Maintaining a statewide, TOLL-FREE Help Line (888-838-7305) so that Nevada beneficiaries have a local resource to resolve and/or research suspicious billings.
The Nevada SMP is here to help you! Please call us if:
- You suspect fraud, errors, waste or abuse to Medicare.
- You would be interested in volunteering with Nevada SMP to provide outreach and education.
- You would like a presentation to your organization or group to learn more about fraud, errors and abuse in Medicare and how to protect yourself from medical identity theft.
Our toll-free number is 1-888-838-7305
Senior Medicare Patrol
Bldg. 1820- Suite 205
1860 E. Sahara Ave.
Las Vegas, NV 89104