decisionhealth Newsletters, Part B News - 2020 Issue 2 (February)
Protect your patients from Medicare scams with proactive education, tips
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Article Overview
This article is a fraud-prevention overview for medical practices, focusing on how to help patients recognize Medicare-related scams and how to be alert to insider abuse in billing. It covers common scam tactics, broad warning signs, the role of government agencies, and examples of improper provider behavior that can create compliance risk. The piece is aimed at clinicians, billers, coders, office staff, and compliance-minded practices that interact with Medicare beneficiaries.
Why This Topic Matters
Medicare scams can harm patients, create financial loss, and lead to downstream billing and compliance issues for practices. Understanding the general scam landscape and fraud-reporting pathways helps offices educate patients, spot suspicious activity, and reduce avoidable risk.
Article Sections
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Patient-facing Medicare scam awareness
Introduces the broader fraud environment and explains why practices may want to educate patients about common Medicare-related scams. Discusses general prevention themes and seasonal or situational risk factors.
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Staggering dollars lost to cons
Reviews high-level estimates and commentary about the scale of health care fraud affecting Medicare and related programs. Includes references to public agencies and advocacy organizations.
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Watch DME and testing scams
Describes common scam patterns involving phone outreach, product-related fraud, and testing-related schemes. Also summarizes general patient responses and reporting options when an unsolicited contact occurs.
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Watch insider fraud, too
Shifts to provider-side fraud and abuse concerns, including billing integrity, suspicious claim patterns, and general compliance risks. Mentions fraud investigations, enforcement examples, and reporting channels.
What You Will Learn
- How Medicare-related scams commonly target patients
- Why patient education can be part of fraud prevention
- Which broad scam categories are highlighted in the article
- How provider-side billing abuse fits into the larger fraud discussion
- What general reporting resources are mentioned for suspected fraud
Who Should Read This
- Physicians
- Practice managers
- Medical billers
- Medical coders
- Compliance staff
- Front-desk and patient-service teams
- Other staff who counsel Medicare beneficiaries
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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