Legal

How to Protect Yourself from Fraud

Keeping Your Information Safe

Many scam artists have found ways to deceive us and steal financial and personal information. Scam artists often see older adults as attractive targets because they’re more likely to have a nest egg, own their own homes and have excellent credit.

It’s important to protect yourself from financial and insurance fraud. To keep your information safe use the following tips:

  • Never sign blank insurance claim forms.
  • Do not do business with door-to-door or telephone sales people who tell you that services of medical equipment are free, or available for no direct cost to you.
  • Don’t give your personal information to anyone who calls you or comes to your home uninvited selling Medicare products. Generally, no one should do this.
  • Call 1-800-MEDICARE to report any plans that ask for your personal information over the phone or call to enroll you in a plan. Medicare plans can’t ask for your credit card or banking information over the phone, unless you’re already a member of the plan. In most cases, Medicare plans can’t call you to enroll you in a plan--you must call them.
  • Only give your insurance/Medicare identification and Social Security number to those who have provided you with medical services.
  • Keep accurate records of all your health care appointments and verify your explanation of benefits and all bills for services.
  • Keep any receipts from providers for health care services and use those receipts to check for any errors on the explanation of benefits statements.
  • Always watch your credit card and bank statements for any improper billing activity or fraudulent withdrawals.
  • Monitor your credit report regularly.

Sometimes scams are not reported because people are ashamed or embarrassed. It is important to know it’s not your fault. If you believe you are the victim of an insurance scam, we are here to assist you. Call 800-378-5234 (TTY 800-947-3529) Monday–Friday, from 8 a.m. to 8 p.m. or email us at paymentintegrity@networkhealth.com.

You can always call our Values Line to report and discuss activities or occurrences you believe are improper. The hotline is confidential and you may report concerns anonymously. Your concerns will be investigated and appropriate action will be taken to address the problem. The Values Line number is 800-707-2198.

Additional Contact Numbers

  • 1-800-MEDICARE (800-633-4227) (TTY 877-486-2048).
  • The Fraud Hotline of the HHS Office of Inspector General at 1-800-HHS-TIPS (800-447-847) (TTY 800-377-4950), or email HHSTips@oig.hhs.gov.
  • The Federal Trade Commission’s ID Theft Hotline at 877-438-4338 (TTY 866-653-4261) or visit www.ftc.gov/idtheft.

What You Should Know about Medicare and Billing Fraud

Medicare fraud, often called billing fraud, happens when Medicare is billed for services or supplies you never received. Medicare fraud costs millions of dollars each year, and it results in higher health care costs.

Here are some examples of possible Medicare or billing fraud.

  • A health care provider bills for services you never received.
  • A supplier bills for equipment different than what was provided.
  • Someone uses another person’s Medicare or member ID card to get medical care, supplies or equipment.
  • Someone bills Medicare for home medical equipment after it has been returned.
  • A company offers a Medicare drug plan that hasn’t been approved by Medicare.
  • A company uses false information to mislead you into joining a Medicare plan.

If you suspect Medicare or billing fraud, here’s what you can do.

  • Call your health care provider to make sure the bill is correct.
  • Call your health care concierge at 800-378-5234 (TTY 800-947-3529) Monday–Friday, from 8 a.m. to 8 p.m.
  • Call 1-800-MEDICARE (800-633-4227) (TTY 877-486-2048).
  • Call the Inspector General’s hotline at 1-800-HHS-TIPS (800-447-8477) (TTY 800-377-4950) or email HHSTips@oig.hhs.gov.  

Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.