Medicare
Overpayment
Detective

SQUAD

The Better Business Bureau Education Foundation of Metropolitan Houston has joined the fight against Medicare Fraud with the development a program titled MOD Squad, otherwise known as Medicare Overpayment Detective Squad.  The MOD Squad is a group of volunteers trained to educate and inform Medicare beneficiaries on how to combat fraud and waste of their Medicare dollars.  This program is funded through a federal grant awarded by the Administration on Aging.

Why fight Medicare fraud?  Because it’s your money, and dishonest use of Medicare dollars negatively impacts both consumers and health care professionals.

What is Fraud?

Medicare fraud is purposely billing Medicare for services that were never provided or received.

Examples include:

• Billing Medicare or another insurer for services you did not receive.

• Billing Medicare for services or equipment which are different from what you got.

• Use of another person’s Medicare card to get medical care, supplies or equipment.

• Billing Medicare for home medical equipment after it has been returned.

You should also be suspicious if someone tells you:

• The test is free, but they need your Medicare number for their records.

• They tell you Medicare wants you to have the item or service.

• They know how to get Medicare to pay for something.

• The more tests they provide the cheaper they are.

• The equipment is free or won’t cost YOU anything.

How You Can Protect Yourself

• Never give your Medicare number to a stranger.

• Always review your Medicare statement carefully.

• Guard your Medicare card like you do your credit cards.

• Don’t fall victim to sales tactics that pressure you or scare you into taking medical supplies or equipment you do not need.

• Never give your Medicare number to anyone offering a free service.  If it is “free” they do not need your number.

• Keep records of all healthcare appointments

• Never sign a blank form, and request copies of everything you sign.

• When in doubt, take the time to ask your doctor or your healthcare provider for clarification of any charges you don’t understand.

Make a Difference!  

You are critical in the fight to prevent fraud and abuse of the Medicare program.  Fighting home health fraud and abuse helps to ensure that the benefit will be available whenever you need it.

 Protect your benefits by:

• Being informed about Medicare benefits,

• Know the type and frequency of the care you receive,

• Know what services your doctor ordered,

• Ask questions about services you receive,

• Report your concerns.

 Or you can join the fight against Medicare Fraud by becoming a MOD Squad Volunteer!

Medicare Overpayment Detectives are volunteers who are trained to educate and inform Medicare beneficiaries on how to combat waste and fraud of their Medicare dollars.  Through presentations and one-on-one counseling, MOD Squad members assist beneficiaries to recognize fraud and how important it is to report the misuse of funds.

Training includes:

• Warning signs of potential fraud.

• Current Medicare fraud schemes.

• How to review a Medicare Summary Notice (MSN) for fraudulent charges.

• Tips to prevent fraud of your Medicare number.

• Join us in our goal to save Medicare dollars from being lost through waste, fraud and abuse!

Questions about the Better Business Bureau Education Foundation MOD Squad?  

E-mail Barbara McGinity at bmcginity@bbbhou.org, or call  713-341-6184.