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Fraudulent Claims There are many estimates of the amount of money paid for fraudulent health care claims each year. Some estimates suggest that for every $7 paid for health care, $1 is for fraudulent activities. What Is Fraud? • Falsifying a claim to obtain benefits • Using an ID card to obtain services for someone not eligible for coverage or who is no longer enrolled • Charging for medical services you did not receive, duplicate billing or misrepresenting any information What Can You Do? • Review all of your health care bills and Explanation of Benefits (EOBs) to make sure you received the services and the dates match. • Let us know if you misplace your Service Benefit Plan ID card or if it is stolen. This card buys important goods for your family. And just like someone can use stolen credit cards to purchase goods, someone can use your ID card to obtain health care services. The Service Benefit Plan is dedicated to identifying and eliminating fraudulent activity. But it takes your help. If you have any questions or suspect fraudulent activity, call the FEP Fraud Hotline at 1.800.337.8440. Medicare also views you as partners in their fight against improper behavior by providers. You can report any such behavior to Medicare by calling 1.800.HHS.TIPS. The hotline, staffed weekdays from 8:30 a.m. to 6:00 p.m., Eastern Time, has both English- and Spanish-speaking operators. |
