How Do Medicare Phone Scams Work
Across the country, seniors may receive calls from scam operators who claim to represent Medicare or a different insurance provider. They usually claim that the seniorâs Medicare card has expired, prompting the release of personal information like name, address, Medicare number, or Social Security number.
From offers for free medical supplies and entitlement to refunds to attempts to verify your identity, all of these calls are examples of a scam you should run far away from.
Sharing personal information with these telephone criminals can result in identity theft, fraud, or monetary theft.
Do Medicare Providers Make House Calls
House calls are making a reappearance in many regions of the United States, according to the Washington Post. A growing number of these house calls are from Medicare providers â like nurse practitioners, home health aides, physical and speech therapists, and doctors. Normally, of course, you either go to a doctorâs office or clinic, or stay in a nursing home or other facility, to see a Medicare provider.
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Provider Enrollment Telephone Numbers
Provider Enrollment inquiries that require assistance of a representative should be made to the applicable customer service jurisdiction telephone number and during the specified time.
- Call 866-276-9558 and select Option 2 to reach a specially trianed customer service representative.
- Hours are 8:00 a.m. – 5:00 p.m. ET
This toll free number is for providers or their representatives who need enrollment information. The customer service staff will not be able to provide status for applications in process. To check the status of your enrollment application, please visit “Checking the Status of Your Application” at .
CGS sends a courtesy letter to providers acknowledging receipt of the application. If the application is complete and accurate it is processed timely. If additional information is required providers will receive a written request within 15 days of our receipt of the application. This request will be by letter, fax or e-mail. Those requests will include the name and phone number of the person processing your application. You may contact that person directly if you have further questions.
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Youre Eligible For A Refund For Overpayment Of Benefits
A common phone and text scam used by fraudsters entails claiming that youâre owed a refund due to overpayment. Medicare scammers wonât hesitate to contact you at home and say that Medicare owes you hundreds or even thousands of dollars. But this is almost always a scam.
ð How to identify a Medicare âoverpaymentâ scam call:
- The caller claims youâre owed money from Medicare but needs your bank account number and personal identification to send you the funds. Giving a scammer this information could make you the victim of identity theft.
- The caller pressures you into giving them sensitive information by saying youâll âloseâ the money if you donât act now. Medicare or an insurance company will never ask you to verify your information before issuing you a refund. They will certainly never ask for your banking details. Donât feel pressured into giving up your information.
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User License Agreement And Consent To Monitoring
End User Agreements for Providers
Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. This includes items such as CPT codes, CDT codes, ICD-10 and other UB-04 codes.
Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. If you choose not to accept the agreement, you will return to the Noridian Medicare home page.
THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. BY CLICKING ABOVE ON THE LINK LABELED “I Accept”, YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK ABOVE ON THE LINK LABELED “I Do Not Accept” AND EXIT FROM THIS COMPUTER SCREEN.
IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THESE AGREEMENTS CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, “YOU” AND “YOUR” REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
LICENSE FOR USE OF “PHYSICIANS’ CURRENT PROCEDURAL TERMINOLOGY”, FOURTH EDITION
Consent to Monitoring
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Best Practices For Calling Medicare Customer Service
Medicare’s phone-based customer support is available twenty-four hours a day, seven days a week, and is even open on some Federal holidays. Individuals who are deaf or have a hearing impairment can use Medicare’s TTY/TDD number.
There are several things that you can do to ensure that your call goes smoothly and that you get the information you need or an appropriate resolution to a problem:
First, Make sure that you are calling the right agency:
- Medicare is not the same as Medicaid, which is a federal health program for low-income individuals. You will have to call Medicaid’s central or regional offices if you need help with Medicaid issues.
- If you are trying to find out whether you qualify for Medicare, need to report the death of someone who receives medicare, want to sign up for Medicare Part A or B, order a replacement card, or need to challenge an income-based increase in your Medicare costs, you will need contact the Social Security Administration.
Next, have a way to take notes during your call. Knowing who you spoke to and what was said during your conversation can be helpful if you have to escalate your case. Be sure to add the date and time of your call to your notes.
Finally, make sure you have your Medicare card in front of you, along with any correspondence from Medicare that is relevant to your case.
Write To Insurance Companies
You may write your insurance companies with questions that you have about your coverage. If possible, type up your letter and make sure to keep a copy that indicates the date on which you mailed it.
If you arent able to type up your questions, make sure to write in clear, concise print, leaving plenty of space in between your questions. Be sure to include your contact information in any correspondence that you mail to your healthcare provider.
Before sending mail that contains important documents or your private health information, call ahead and make sure that you have the correct contact information. Mail that is sent to the wrong address is not always forwarded to the right place, especially in places that receive a high volume of mail.
Addresses for major insurance companies that provide Medicare policies:
If your ability to talk on the phone is limited because of a health condition, you can still reach out to Medicare. TTY users can call 1-877-486-2048 to reach a hotline compatible with their devices.
You can also email Medicare at [email protected], or send a letter explaining your need to:
Centers for Medicare & Medicaid ServicesOffices of Hearings and Inquiries 7500 Security Boulevard, Mail Stop S1-13-25Baltimore, MD 21244-1850
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Can I Call Medicare For Help With My Coverage
You can call Medicare anytime for help with your coverage. The number to call is 1-800-MEDICARE . The TTY number is 1-877-486-2048.
This phone number is meant to be a general resource for questions you have about your Medicare coverage. You can check the status of your claims, inquire about your premium and deductible costs, and more.
Here are other important phone numbers for issues relating to Medicare benefits:
- Centers for Medicaid and Medicare Services can provide information about upcoming Medicaid events, such as health fairs and seminars. The telephone number for their national office is 1-800-772-1213.
- The Department of Veteran Affairs can give you information about how your military benefits work with Medicare. Their nationwide phone number is 1- 827-1000.
- Your State Health Insurance Assistance Program can give you personalized counseling as you choose the Medicare and health insurance options that are right for you. These programs give advice based specifically on the state in which you live. The SHIP national hotline is 1–701-0501.
- To report a lost Medicare card or if you are trying to change your address with Medicare, you may need to call the Social Security Administration office. Their national hotline is 1 772-1213.
End User Point And Click Agreement
CPT codes, descriptions and other data only are copyright 2012 American Medical Association . All Rights Reserved. Applicable FARS/DFARS Clauses Apply.
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services . You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, .
Applicable FARS/DFARS restrictions apply to government use.
U.S. Government Rights
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What Do I Do If I Receive A Medicare Scam Call
If you receive a Medicare scam call, hang up.
Speaking to the Medicare phone scammers, even to tell them off, can encourage more scammers to call your number. If calls persist, consider discussing certain scam blocking features with your phone company.
After receiving a Medicare scam phone call that asks for your Medicare number or other personal information, reach out to 1-800-MEDICARE â TTY:â¯1-877-486-2048.
If you have already discussed personal information on the phone that you now believe is in the wrong hands, contact the Federal Trade Commission to protect yourself from the damages of identity theft.
Providers Who Opt Out Of Medicare
Providers who opt-out of Medicare enter into private contracts with beneficiaries.
- Medicare doesn’t pay for services you receive from opt-out providers.
- TRICARE pays the amount that would have been paid had Medicare processed the claim.
- You may be responsible for about 80% of the cost for the care.
In cases where your access to medical care is limited , TRICARE may pay the claim as the primary payer.
When using TRICARE For Life, you can get care at a military hospital or clinic, but only if space is available. > > Find a Military Hospital or Clinic
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License For Use Of Dental Procedure Codes Fourth Edition
End User Point and Click Agreement
These materials contain Current Dental Terminology, is copyright by the American Dental Association. Â© 2012 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.
THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED âI ACCEPTâ, YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED âI DO NOT ACCEPTâ AND EXIT FROM THIS COMPUTER SCREEN. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, âYOUâ AND âYOURâ REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
Reporting Fraud Waste Or Abuse To Us
When you report a situation that could be considered fraud, youre doing your part to help save money for the health care system and prevent personal loss for others. If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it. Taking action and making a report is an important first step. After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in the health care system.
Call us at or visit uhc.com/fraud to report any issues or concerns.
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How Do I Prepare Before Calling Medicare
Before picking up the phone to dial the Medicare phone number, take a minute to get ready for the call. Make sure you have:
- Your Medicare number thats printed on your Medicare card. The automated answering system will ask you for your number at the start of the call.
- Pen and paper to take notes. Its a good idea to write down the time you called, who you talked to, and the answers to your questions.
If you call Medicare about a claim, youll need some additional information:
- Your doctors name
- The date you received the service
- How much youve already paid
Where Else Can I Get Medicare Advice
State Health Insurance Assistance Programs are free volunteer-based Medicare counseling services available in each state. These programs provide unbiased counseling about Medicare questions including details about coverage, benefits, and costs . SHIPs can also assist beneficiaries with complaints or appeals. Importantly, SHIPs can also assist with coverage changes like choosing the right Medicare Advantage or Part D plan for your needs.
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Medicare Provider Phone Number
Customer service contact information for Texas’ Medicare administrative claims contractor – Novitas Solutions, Inc. is:
For Jurisdiction H – Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, Indian Health Service/Tribal/Urban Indian Providers and Veterans Affairs Providers, call our toll-free number: 1-855-252-8782.
Our Single Toll Free Telephone Customer Service Units, including provider services, EDI helpdesk, Enrollment and Claims Corrections are available:
- JL: Monday Friday 8:00 AM 4:00 PM EST
- JH: Monday Friday 8:00 AM 4:00 PM CT and MT
Find A $0 Premium Medicare Advantage Plan Today
For California residents, CA-Do Not Sell My Personal Info, .
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.
The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier. TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.
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Coba Trading Partner Contact Information
The Coordination of Benefits Agreement Program establishes a nationally standard contract between CMS and other health insurance organizations that defines the criteria for transmitting enrollee eligibility data and Medicare adjudicated claim data. CMS has provided a COBA Trading Partners customer service contact list as an avenue for providers to contact the trading partners. The COBA Trading Partners document in the Download section below provides a list of automatic crossover trading partners in production, their identification number, and customer contact name and number. For additional information, click the COBA Trading Partners link.
Medicare Scam Phone Calls That Seniors Should Avoid
While we choose to believe in the good in people, itâs always best to be cautious just in case. Seniors receiving Medicare are commonly targeted by scammers who are on the hunt to steal identities, money, or more. Medicare scam phone calls specifically ramp up during Medicare Open Enrollment, which takes place annually, October 15 â December 7.
As we approach this important time, it is vital that you are aware of what Medicare scam phone calls are out there and what to do if you receive them, so that you can better protect yourself and your loved ones.
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Hard Facts About Medicare
Here are some important things for seniors to know about how Medicare and the Social Security Administration function.
- Medicare generally wont call you, except in limited circumstances. One such exception is if you have called 1-800-MEDICARE and requested a return call.
- Medicare will never call or come to your home uninvited to sell products or services.
- SSA representatives may call Medicare beneficiaries if they need more information to process applications for Social Security benefits or enrollment in certain Medicare Plans, but, again, this is rare.
- If a phone call is needed, youll receive an official letter from the SSA to arrange a telephone interview.
- Medicare cards do not expire, so be wary of someone saying they need to send you a new one.
- If your card is lost or destroyed, contact the SSA directly to request a replacement. If you think someone else is fraudulently using your Medicare card, then call Medicare directly at 1-800-MEDICARE .