Some months back, there was discussion on my NextDoor page about a common Medicare fraudulent claim. I took a look and found one like it on my record, so I called Medicare to report it. Complete waste of time. Could not get the phone rep to comprehend that I was reporting fraud and I don’t think there was any follow up.
Last week, I got a regular email notice of recent Tricare claims and checked (as I now do with Medicare). Tricare had denied a claim that I could tell was fraudulent, but I had not yet heard from Medicare. So, I logged into Medicare and found a large fake claim that Medicare had already paid.
The claim had been filed in December, but it covered 10 monthly charges of $1900, dating from Feb 2023 to Nov 2023. Total claim was $19,000 and Medicare had paid $15K of that, then sent it to Tricare, who, properly, balked.
Each monthly claim was for “200 Intermittent urinary catheter, with insertion supplies (A4353-KX).” Geez, that’s not fun even to read. Physician was some starkly unpronounceable southern Asian name in Fort Lauderdale.
This time, I found a “whistle blower” link on the Medicare site and made an online report. Yesterday I received a new Medicare card and number, so the report worked.
Y’all watch out, y’hear?
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Originally Posted by Rockindaddy
DougGuy
