Norma Kop

  • Beware of Medical Identity Theft

    When Aunty Lei’s Medicare Summary Notice showed lab test charges she didn’t recognize, she called SMP Hawai‘i, a volunteer-based federal program that helps prevent Medicare fraud through education. The counselor helped her report the fraud, document each detail and understand how scammers target kūpuna through their Medicare numbers.

    But Aunty Lei also wondered if these false charges would affect her benefits and future claims, so she was referred to Hawai‘i State Health Insurance Assistance Program (SHIP). SHIP offers free, confidential and unbiased counseling, outreach and education to help Medicare beneficiaries make informed decisions about their health coverage. A SHIP counselor helped review her Medicare plan and check her claims, and also taught her how to read her statements and understand her rights.

    SMP protected her from fraud, while SHIP helped her understand and resolve Medicare issues.

    Protect yourself:
    ❶ Never share your Medicare or Social Security number with unexpected callers;
    ❷ Review your Medicare Summary Notices and Explanation of Benefits regularly and
    ❸ Watch for bills, supplies or services you didn’t request.

    SMP HAWAIʻI & HAWAIʻI SHIP
    250 South Hotel St., Ste. 406, Honolulu, HI 96813
    SMP HAWAIʻI
    808-586-7281 | 1-800-296-9422 | smphawaii.org
    HAWAIʻI SHIP
    808-586-7299 | 1-888-875-9229 | hawaiiship.org

    When Aunty Lei’s Medicare Summary Notice showed lab test charges she didn’t recognize, she called SMP Hawai‘i, a volunteer-based federal program that helps prevent Medicare fraud through education. The counselor helped her report the fraud, document each detail and understand how scammers target kūpuna through their Medicare numbers. But Aunty Lei also wondered if these…

  • Help Prevent Medicare Fraud & Abuse

    Medicare fraud poses a significant threat to the integrity of healthcare systems, leading to increasing healthcare costs and undermining trust. Medicare loses an estimated $60 billion annually due to fraud, errors and abuse, but the actual figure is difficult to measure. Medicare fraud and abuse can block people’s access to potentially lifesaving services and benefits. Educating yourself and your loved ones on how to prevent Medicare fraud, errors and abuse is the best place to start.

    Understanding Medicare Fraud

    Medicare fraud involves the intentional deception or misrepresentation that results in unauthorized benefits. Common examples are as such:

    Phantom billing: Charging for services or equipment not provided.

    Patient billing: Using a beneficiary’s Medicare number for false claims.

    Upcoding: Billing for more expensive services than those actually performed.

    Kickbacks: Receiving incentives for patient referrals or prescribing specific products.

    Preventing Medicare Fraud

    Beneficiaries should be vigilant:

    Protect personal information: Never share Medicare numbers with unverified groups.

    Review statements: Regularly examine Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) for inconsistencies.

    Avoid unsolicited offers: Offers for free medical services or equipment may be scams.

    Detecting and Reporting Fraud

    To identify potential fraud:

    Verify services: Ensure all billed services were received and necessary.

    Check provider legitimacy: Confirm that providers are reputable/services were authorized.

    If fraud is suspected:

    Contact providers: Discuss billing concerns with healthcare providers.

    Report to authorities: Reach out to the Senior Medicare Patrol (SMP) or the Office of Inspector General.

    Senior Medicare Patrol

    SMP Hawaii is a federally funded volunteer program that empowers and assists Medicare beneficiaries to prevent, detect and report healthcare fraud. By staying informed and vigilant, we all can play a crucial role in identifying and mitigating dishonest activities.

    SENIOR MEDICARE PATROL (SMP) HAWAII
    1-800-296-9422 | info@smphawaii.org
    smphawaii.org | Facebook: smphawaii808

    Medicare fraud poses a significant threat to the integrity of healthcare systems, leading to increasing healthcare costs and undermining trust. Medicare loses an estimated $60 billion annually due to fraud, errors and abuse, but the actual figure is difficult to measure. Medicare fraud and abuse can block people’s access to potentially lifesaving services and benefits.…