My Medicare Summary Notice shows a charge for a service that I did not receive. Is this fraud?

Answer:

You should check your Medicare Summary Notices carefully to verify that you received the services that Medicare paid for. If you do not recognize a particular service that does not necessarily mean that fraud has been committed. For example, it is possible that you received the service, but the provider name or service description is unfamiliar.

If you identify an erroneous charge on your Medicare Summary Notice, you should call the number listed in the Customer Service Box in order to speak with the Medicare-contracted insurance company that processed the claim. A representative will be able to access your records via computer, and may be able to determine immediately whether the service charge represents a billing error, a misunderstanding on your part, or a potential instance of fraud.

If you are unable to reach the Medicare contractor, or if so advised by the contractor representative, you may also report the charge to the Inspector General's Hotline at 1-800-HHS-TIPS (1-800-447-8477).

See more Frequently Asked Questions about Medicare fraud, waste, and abuse at: http://questions.medicare.gov/cgi-bin/medicare.cfg/php/enduser/std_alp.php?p_cv=1.69&p_pv=&p_cats=69&cat_lvl1=69

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Last Updated: 04/01/2008