Medicaid Fraud

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WHAT ARE THE SIGNS THAT THIS IS A SCAM?

You have been charged the incorrect co-payment or amount for your prescription drugs or medical treatment.

Your medical provider gives you generic medication but bills for the brand name medication.

You receive a phone call requesting you provide your Medicaid number for services you can't recall receiving.

You receive a bill for charges you know have already been paid for by Medicaid. You question why the provider is billing for these services again and find it appears to be coded differently.

You receive a bill for services or procedures that should have been free.


HOW CAN CONSUMERS PROTECT THEMSELVES?

Incorrect billing by providers may just be a simple error and not fraud. The important thing to do is ask questions. Contact the provider immediately to inquire about all questionable charges.

"Phantom" billing occurs when a provider bills for services that have not been performed and is paid accordingly. Providers may also "up code," which happens when a provider bills or codes for a more expensive service than what was rendered. Ask your provider about any questionable services on your bill.

Always ask any caller for proof of identity as a provider if they ask for your Medicaid number over the phone. You can also call them back at the office to ensure they are a legitimate provider. It is important to safeguard your Medicaid number to prevent fraudulent billing.


HOW TO REPORT IF YOU'VE BEEN A VICTIM

Medicaid Consumer Hotline: To report any activity you suspect is Medicaid fraud or if you have questions concerning services or billing you do not understand, call 1-800-324-8680.