Q: In the past I’ve heard about Medicare fraud and how important it is for everyone to fight it. I’m sure fraud occurs in all areas of care but am concerned with services provided by in-home agencies. What red flags would you suggest we look for?
A: You are correct. Fraud occurs in all areas of our health care system. Although most home health care agencies are honest, a few commit fraud.
To know if billing for services is correct you need to be aware of two things. First you need to understand exactly what services your doctor has prescribed for your care. You will also need to educate yourself as to what Medicare does and does not cover
If there is something in your care plan that you don’t understand, ask questions. Continue to ask until you are satisfied that you understand what services you are to receive and what to expect from those services.
Don’t hesitate to question the in-home health care agency about visits by the home health care staff that you feel are excessive or unneeded. Always check your Medicare Summary Notice carefully. Make sure the dates of service match the dates you were visited and that the description of the care provided is correct.
Always question payments made for services or equipment that you never received. Never give in to pressure to accept services or equipment that you know are not prescribed as part of your 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 those changes.
Be suspicious of any agency that offers you free services or equipment in exchange for your Medicare number. Treat your Medicare and Medi-Cal numbers like they were cash or credit cards and never give your number to anyone who doesn’t have official need for it.
If you suspect fraud, call Medicare at the Customer Service telephone number on the front of your Medicare Summary Notice. Each call will be taken seriously.
HAPPENINGS:
Today: “Medicare 2015” seminar at the Thousand Oaks Council on Aging Meeting, 1 p.m., Civic Arts Plaza, Board Room, 2100 E. Thousand Oaks Blvd. in Thousand Oaks.
Nov. 12: Path to Positive Aging Series presentation — “Advanced Alzheimer’s disease: Knowing and Planning for What’s Ahead.” 5:30-7 p.m. at Senior Concerns Day Care Center, 401 Hodencamp Road in Thousand Oaks. For information and reservations call 497-0189.
Nov. 15: Memory Screening Day. 9 a.m. to 1 p.m. at Senior Concerns Day Care Center, 401 Hodencamp Road in Thousand Oaks. Screenings given in English and Spanish by reservations. For information and reservations call 497-0189.
Nov. 16: “History Comes Alive” presentation. Ed Lawrence, pictorial historian, provides the “Mid-1950”s Conejo Valley with a narrative about early pioneers. 2 p.m. at the Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. For information call 381-2744. Tickets are $5.
Nov. 19: “Senior Safety During the Holidays,” 1:30-3 p.m. at Westlake Village Civic Center, 31200 E. Oak Crest Drive in Westlake Village. For information call 495-6250.
MEDICARE ONE-STOP-SHOPS
Friday: 9 a.m. to 3 p.m. at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks.
Nov. 10: 1-3 p.m. at Moorpark Active Adult Center, 799 Moorpark Road in Moorpark.
Nov. 12: 9 a.m. to 2 p.m. at Camarillo Health Care District, 3639 E. Las Posas Road in Camarillo.
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