Q: I’ve heard about Medicare fraud and how important fighting it is. But if someone was receiving in-home care, what would be some fraud “red flags”? A: Although most home health agencies are honest, a few commit fraud. To know if billing for services is correct, you must know two things: what services your doctor has prescribed for your care and which services Medicare covers. Ask questions if you don’t understand something in your care plan. Continue to ask until you are satisfied that you understand what services you are to receive and what to expect from them. Don’t hesitate to question the in-home agency about visits by the home health staff that you feel are excessive or unneeded. Always check your Medicare Summary Notice carefully. Make sure the dates of service match the dates of your visits and that the description of the care is correct. Always question payments for services or equipment that you never received and never give in to pressure to accept services or equipment that you know are not part of your approved care plan. The doctor approving your home health service should be involved in your care. If changes to your care are suggested, your doctor should be involved in determining and approving those changes. Be suspicious of any agency that offers you free services or equipment in exchange for your Medicare number. Never give your Medicare and MediCal numbers to anyone without an official need for it. If you suspect fraud and are calling from Ventura County, call 800-434-0222. From outside Ventura County, call 477-7310. Q: I am concerned about the number of appeals for money I receive in the mail. How can I tell whether they are legit? A: There are a number of steps you should take before opening your checkbook. Read the appeal thoroughly to make sure it clearly identifies the charity and the programs it serves. Is it really from the organization you think it is? Many solicitors deliberately use a name similar to a well-known agency’s hoping you think you recognize the name and respond. How does the charity use its funds? The majority of money collected should go directly to the programs offered. Watch out for statements such as “All proceeds will go to the charity.” This can mean that money left after the fundraising expenses will go to the charity. Fundraising expenses can be very high depending on the type of event planned. Don’t be overly influenced by stories or pictures in the literature or a celebrity sales pitch. Concentrate on the substance of the message. Do the goals and methods coincide with your beliefs? When making a contribution, pay by check, never cash, and make the check payable to the charity, never to the person making the request. HAPPENINGS Friday: “Will You Pass Your Next Driving Test?” seminar. 1:30-3 p.m.; Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks. For information or reservations, call 381-2744. Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362, or call 495-6250 or email firstname.lastname@example.org . Please include your telephone number. More …
Betty Berry tells readers how to avoid in-home health care fraud
About the Author: Betty Berry
Betty Berry brings a deep understanding of senior issues to her position as Senior Advocate for Senior Concerns. She has advocated for seniors since 1993. Through the Health Insurance Counseling Advocacy Program, known as HICAP, she is registered with the State of California as an Insurance Counselor, a Long-Term Care Insurance Counselor and a Community Educator. She has served on the Area Agency on Aging’s Advisory Council as a member and Chair, has been a member of the Financial Abuse Strategic Team (FAST) and currently serves on the Conejo Senior Volunteer Program (CSVP) Advisory Board and authors the Senior Advocate column that appears in the Ventura County Star. Betty completed her undergraduate degree at California Lutheran University and earned her Juris Doctorate degree at Ventura College of Law.
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