This program is funded by the Administration of Aging to provide outreach and education on Medicare fraud, errors, and abuse. For more information and how you can become involved, please visit our Ferret Out Fraud/SMP Facts Page.
How to Report Fraud, Errors and Abuse
If you believe Medicare is being cheated, call or write the Medicare company that paid the claim. The company name, address and telephone number are on the Medicare explanation of benefits form you received which shows what Medicare paid and to whom.
Before contacting the Medicare claims processing company, carefully review the facts as you know them and as shown on the explanation of benefits. Write down:
The provider's name and any identifying number you may have.
The item or service you are questioning.
The date on which the item or service was supposedly furnished.
The amount approved and paid by Medicare.
The date of the explanation of benefits.
The name and Medicare number of the person who supposedly received the item or service.
The reason you believe Medicare should not have paid.
Any other information you may have showing that the claim for the item or services should not have been paid by Medicare.
If you plan to write rather than call, clearly state at the beginning of your letter that you are filing a fraud complaint. This will help to ensure that your complaint is forwarded to the fraud unit.