The Virginia SMP is here to help with your healthcare fraud complaints. When Medicare beneficiaries, caregivers, and family members bring their complaints to the SMP, the SMP makes a determination about whether or not fraud, errors, or abuse is suspected.
When there are Medicare errors, in many cases the SMP is able to help you resolve the issues with your doctor or your insurance company. They are also able to connect you with other resources that may help remedy the situation.
When fraud or abuse is suspected, the SMP will work with you to collect information necessary to build a case. The case will then be referred to the appropriate state and federal agencies for further investigation.
Here are steps SMPs recommend beneficiaries take to report their concerns:
- Call the health care provider. Call the provider or supplier first to question the charge. If it was a mistake, ask them to correct it.
- Call the company that paid the bill. If the provider or supplier can’t answer the question, contact the company that paid the bill. Their contact information can be found on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB).
- Contact the Virginia SMP. If you are not satisfied with the response you get from a provider, supplier, or billing company, you can contact your local SMP. To report fraud, call the toll free fraud hotline at 1-800-938-8885. You will be asked to leave a message. Be sure to include your name, telephone number and a brief description of the issue. An SMP representative will return your call within 24-48 hours.
The Senior Medicare Patrol Project is supported by Grant #90-MP-0040/01 from the Administration on Aging, Department of Health and Human Services, Washington D.C. 20201