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
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
"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.
Copyright 2011. Hamilton County Ohio. 138 E. Court Street, Cincinnati, OH 45202.
Information on this site is for informational purposes only and is believed to be true and accurate. This information should not be considered as legal advice and Hamilton County disclaims any liability for errors or omissions. External links to other sites are intended to supplement information on this website and do not have the endorsement of Hamilton County.