Protect Yourself

3 step method to help STOP Medicare Fraud!

1. Protect Your Personal Information
2. Review Your Medicare and Medigap / Secondary Insurance Claim Notices
3. Contact the Provider

Step 1. Protect Your Personal Information

• Don't give our your Medicare or Medicaid number to strangers.
• Don't buy products or services from people claiming they are from Medicare. Medicare never endorses products or services from a particular company.
• Medicare does not solicit business by going door to door or calling you on the telephone. Hang Up! or Slam The Door!
• Don't let anyone have access to your medical or prescription records without the approval of your physician or pharmacist.
• Your Medicare number is usually your Social Security number. Do not put your social security number on your drivers license or checks.
• If you suspect someone has stolen your identity, place a fraud alert on your name with credit bureaus and Social Security.
  The telephone numbers are:
  Equifax: 1-800-525-6285
  Trans Union: 1-800-680-7289
  Experian 1-888-397-3742
  Social Security Fraud Line: 1-800-269-0271
• Don't let someone use pressure or scare tactics to sell you medical equipment, supplies or health insurance.
• Shred all papers that have your Medicare, Social Security number or any other personal information on them before throwing them away. If you do not have a shredder use a black permanent marker to black out all personal identification numbers, names and addresses.

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Step 2. Review Your Medicare and Medigap / Secondary Insurance Claim Notices

The Medicare Summary Notice (MSN) is the paper you receive in the mail that says "This is Not A Bill" on it. The Medicare claims process works like this:

You see your doctor or provider who provides a service to you. The Provider bills Medicare. Medicare pays the claim under your Medicare number. Medicare sends you a MSN telling you that they have paid for the services listed. It is your responsibility to make sure the charges were correct.

What to look for on your MSN:

• Dates of service. Did you receive those services from the provider on that date?
• Duplicate payments for the same service.
• Items or services being paid that you don't have a record of receiving.
• Items or services your doctor did not order.

Tip: Request our Personal Health Care Journal
This journal helps you keep track of your physician visits, the services you received on that visit and any special instructions you were given. You can use this when you are checking your MSN to make sure the dates of service are correct and you received the services.

There is also space to record: Medications, Surgeries and medical equipment purchased.

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Step 3. Contact the Provider
If you have questions about the dates of service or services being charged to Medicare. Call the provider listed on the Medicare Summary Notice (MSN).

• They may have filed a claim using the wrong Medicare number.
• They may have entered in an incorrect date of service.
• These mistakes can be taken care of thru the providers billing office.
• Be sure you receive a new MSN from Medicare showing the corrections. If you do not receive a corrected MSN contact Medicare at 1-800- 633-4227 to request a copy.
• If you do not feel comfortable contacting the provider or do not receive satisfaction, please contact the South Dakota SMP by using the Report a Concern button on this website. We will contact you to discuss your concern.

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