Senior Medicare Patrol program helps with Medicare billing
Get help from the Senior Medicare Patrol Program, commonly called SMP. It is a free service that helps senior citizens and their caregivers with a variety of medical billing issues, in particular with helping people avoid abuse in the system. SMP will provide information on Medicare terms and conditions, provide fraud detection services, help with billing issues and more. Find details on the Senior Medicare Patrol Program and the resources provided.
The free service is offered nationwide, not only to people on Medicare but also their caregivers. Most states and local Area Agencies on Aging centers that are in your area operate the Senior Medicare Patrol. The goal of this program is to ensure seniors, especially those who are Medicare or Medicaid beneficiaries, are billed accurately with a secondary goal of helping older people (or their caregivers) identify fraud, scams, and abuse in the system.
Free services provided by the SMP program
The United States Administration on Aging, which has local partner offices in all major cities, town and cities, originally created the program as an anti-healthcare fraud service. People who work as Senior Medicare Patrols are located throughout the nation and a number of volunteers also participate in the program. Each person who participates will do their best to help senior citizens and the elderly. SMP will ensure that they are empowered to address issues of medical billing errors, health care fraud, prevent senior scams, abuse and other related issues.
Professional staff and SMP volunteers coordinate the programs. At these sessions, or local senior centers, the staff can meet with individuals to provide education, advocacy, and help to people on Medicare (whether supplemental plans or from the federal government) in order to identify and prevent Medicare abuse. They will also report on other health care issues such as internet drug scams and identity theft to name but a few. Services will vary by state and Agencies on Aging office, but in general Senior Medicare Patrols (SMP) will offer the following resources.
Workshops and presentations. These are held in local communities for groups of senior citizens, their caregivers and others who need assistance with medical bills or who are concerned with fraud. The sessions are usually held at Agencies on Aging offices, and they will cover the various types of abuse and fraud that occur. The sessions will help people identify common errors. They will review with individuals the steps that seniors can take to protect themselves from these issues.
- Sessions will provide information of government health care such as Medicare and Medicaid. Learn your rights, what these programs typically provide, and how much seniors and others may typically need to pay for their medical costs including prescription medications from Medicare part D.
Receive one-on-one counseling from the Senior Medical Patrol at an Agency on Aging center near you. For example, many people have questions about possible incorrect medical bills. Many senior citizens also need help in understanding their health care documents, or want to know how to identify Medicare or Medicaid fraud. This is when Senior Medicare Patrol counselors can really help. They are available to assist seniors with understanding their bills, review their cases and other paperwork.
Get help with billing errors from the Senior Medicare Patrol Program. The clients help older people, or their caregivers, understand the various Medicare components (Part A, B, C, D) and the benefits provided. Some of the more common examples of incorrect billing or health care fraud can include:
- Double billing, which is charging more than once for the same service.
- Billing for services or medical equipment that was not ordered, or that was different from what was provided.
- Upcoding, which is billing a senior for more expensive care or a service when a less expensive, non-covered item was provided.
- Changing or altering claim forms to obtain a higher payment amount from Medicare.
- Falsely reporting to the patient or government that certain types of services or health care is medically necessary when they are not.
- SMP staff helps caregivers find, and access, government benefits for themselves or the senior, including financial help from the government for caregivers.
- Billing for home health care or medical equipment after it has been returned to the provider.
- Unbundling involves charging the senior a higher amount on their care than if they are combined and billed as one service.
- Other assistance from the Senior Medical Patrol can help with Identity Theft, Home Health Care Fraud, Explanation of Medicare Summary Notice (MSN) & Explanation of Benefits (EOB).
- They also help people identify Wheelchair and Scooter Scams, and arrange General Consumer Protection.
Tips from Senior Medicare Patrol to identify Medicare billing errors
Medical providers, doctors, or even insurance companies that offer supplemental Medicare coverage, are known to push the limits in trying to bill senior citizens who have government insurance. Some of the tips and recommendations from Senior Medicare Patrol Specialists will have include the following. Or read more on medical billing errors.
- Always be sure to request, and closely review, the explanation of your Medicare summary notices (MSN) as well as Medicare/Medicaid benefits (EOMB). This is true for Medicare Part C (Advantage Plans) to Part A coverage for a hospital or others. These benefit statements need to properly reflect services that you received from your doctor or hospital, and the Senior Medicare Patrol staff can help with this process. The payment notice will tell you what you owe, what health care services or supplies were billed to Medicare, and exactly what the Medicare program paid towards your bills.
- Be sure to closely review all bills and statements for any charges that seem wrong to you. This can include services not ordered by your doctor, charges for something you didn’t get (such as medications), or billing for the same health care service twice. If you did happen to spend time in a hospital from Medicare Part A make sure this was billed accurately. Review the admission date, discharge date, and ensure the diagnosis and details on your medical bill is correct.
- As part of the SMP process, keep accurate and detailed records. You can do this by simply using a calendar to record all of your doctor's appointments. Note which services were provided, such as tests or X-rays. Then, once you get your medical bill or Medicare statement, be sure to carefully check it to make sure you received each service listed and that all the details on the statement are correct. Click here for other methods to use for reducing medical bills, including how to get medical bill reduction from advocates.
- Another small suggestion is to always count your medications and pills before your leave the drug store to be sure you have received the full amount. If you notice that you did not receive your full prescription, then report the problem immediately to the pharmacist.
Applying to and phone number for Senior Medical Patrol
To learn more about the Senior Medicare Patrol program (SMP), fraud, and billing issues, contact your local Agency on Aging office. There is also an online SMP website to help find local SMP programs. Or dial customer service at the SMP resource center, and that number is 877-808-2468.
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