Senior Medicare Patrol Warning about Medicare Fraud
Transcript of video:
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[Music]
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[Applause]
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[Music]
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each year billions of american taxpayers
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dollars are wasted on improper payments
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to individuals organizations and
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contractors
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these are payments made in the wrong
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amounts to the wrong person or for the
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wrong reason it is estimated a loss of
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64 billion dollars annually results from
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fraud abuse or errors involving medicare
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and medicaid
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[Music]
0:49
[Applause]
0:50
[Music]
0:57
welcome to our program on health care
0:58
fraud and abuse if you or someone you
1:01
know receives medicare or medicaid
1:03
benefits we hope this program will help
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you
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understand more about medicare fraud and
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abuse and what you can do to help
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prevent it and protect yourself from
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becoming a target
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my name is paul obitai and i'm the
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program manager of cross county service
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link
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one of 10 service link resource centers
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throughout new hampshire
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we provide information and connections
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to resources that help older adults and
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families make informed decisions about
1:30
independent living at service link we
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listen to your needs respect your
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privacy
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and help you find answers and we also
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support family caregivers explain
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long-term care options and assist with
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medicare issues
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helping people who receive medicare
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benefits understand how they can protect
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themselves from fraud and abuse is an
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important piece of our medicare work and
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it is the focus of our program today
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joining me is carol german
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carol is the state director of new
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hampshire senior medicare patrol and
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becky roston who works on medicare
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issues at the service link resource
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center in claremont which covers
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sullivan county
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as you just saw in the opening of this
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program
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medicare fraud abuse costs american
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taxpayers a great deal of money each
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year
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money that could be better used for
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health care benefits
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to help prevent these losses a national
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program called senior medicare patrol or
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smp is working in every state to help
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medicare medicaid beneficiaries
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learn
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how to prevent detect and report health
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care fraud
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through educational programs in the
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community and through individual help
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for persons with concerns about their
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medicare
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here in new hampshire our s p programs
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are located at each of the service link
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resource centers throughout the state
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and they offer educational programs
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about health care fraud and abuse in the
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community
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and individual help for anyone with
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concerns about their medicare accounts
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often people wonder what is meant by
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medicare fraud what does it look like
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carol can give a few examples of what we
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mean by medicare fraud and how people on
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medicare
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can become targets
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sure paul
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basically medicare fraud is like
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stealing and it's intentional
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it could involve billing for a service
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that wasn't received
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you might see a charge on your medicare
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summary notice for something that you
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didn't get or that your doctor never
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ordered
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or it could be a scam with someone
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coming to your door or calling you on
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the phone and offering you something for
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free in exchange for giving them your
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medicare number
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the administration on aging has done a
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great job in showing some of these scams
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at work and explaining what you should
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watch for and do if anything like this
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happens to you
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let's watch
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i've already got eight medicare numbers
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and i'm going for number nine
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these prescription drug cards look just
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like the real thing
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like medicare would really pay for a
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housekeeper
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some people will believe anything
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the people you just saw are actors but
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the scams they're acting out aren't made
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up they really happen and they're likely
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to keep on happening but if you know
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what to watch for they won't happen to
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you if you can remember three words
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protect detect report
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i'll help you through the rest
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the hard part is without the music and
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the sound effects the bad guys can be
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hard to spot they appear to be very
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helpful people
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this is packed with nutrients and
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vitamins to keep you healthy you're not
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the only one confused by medicare part d
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but the plan that we're offering is
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actually completely straightforward and
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at a very low price
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just a flat fee of 299. so i'll send
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someone once a week to give you a
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medical checkup and clean your house
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and then i'll submit this form to
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medicare and they'll cover my fee
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those friendly people are involved in
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some of the most common medicare scams
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around
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scams that cost both the government and
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you
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it's obvious when you think about it
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when medicare pays out to people like
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them there's less money available for
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legitimate medicare claims
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fraudulent medicare claims add up to
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billions of dollars every year so it's
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worth taking a closer look
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let's start with the phone scam
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i'm with medicare and we're calling to
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help you understand our medicare part d
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did you hear the first red flag
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i'm with medicare
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a lot of people work for medicare but
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they are not allowed to make cold calls
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no you don't have to pay me the 299 now
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i can bill you for it but first i
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actually need to verify your medicare
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number
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uh do you have your card handy so you
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could read me that number
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red flag number two did you catch it
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you might think this is only about
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cheating you out of 299 dollars but
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you're wrong
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your medicare number is worth more to
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him than 299 that comes out of your bank
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account
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with that information he can steal your
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identity set up fake credit cards order
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equipment or worse
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it's critical that you protect that
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number let me read that number back to
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you
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432 if this guy really worked for
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medicare he wouldn't need to ask you for
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your number over the phone he'd already
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have it
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sometimes the story changes
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the cost of the iraq war is taking money
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from medicare
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and if you're relying on that you could
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be in trouble
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i'm calling to offer you an alternative
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prescription plan it's just 2.99
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yup that's right it's only 2.75
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yep that's right it's just 329.
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of course the art of stealing medicare
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numbers doesn't just happen over the
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phone
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hi i work with the health department and
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we're delivering these free nutritional
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supplements to people who are on
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medicare it's part of a preventative
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health care program and all you need to
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take part is proof that you're a
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medicare recipient
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i take vitamins i don't need that well
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our research shows that because vitamins
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can get expensive people tend to stop
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taking them as they get older which is
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precisely when they need the most that's
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why we deliver these free every week so
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you'll be more likely to keep up your
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healthy habits i just need to see your
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medicare
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card just a minute
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free
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did that word send off the alarm bells
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ringing in your head
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if it sounds too good to be true it
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probably is
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once you know what medicare covers you
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can detect frauds like this and avoid
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being part of them
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okay
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i'll just record your number
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now that he has her number he can make a
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medicare claim
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and you know nutritional supplements
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aren't the only thing he delivers
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state-of-the-art wheelchairs scooters
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diabetic supplies
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heating pads
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most of the time what he delivers is not
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what the doctor ordered but once he
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delivers something he can make a claim
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the bill goes to medicare and he pockets
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the profit
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what you'll probably start with is the
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laundry
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the laundry
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the government doesn't do laundry
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what else does she do oh she does a
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great job on windows
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and the government definitely doesn't do
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windows
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medicare is strictly medical but there
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are plenty of people who are offered to
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clean your house bring you groceries
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even wash your hair on medicare's dime
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so i just submit this form to medicare
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every week and all we need from you now
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is your signature on the registry your
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name and your medicare number do you
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have that card sir
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excellent so let's uh start with the
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signature right there
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again with a medicare number by now you
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know the story she offers a little then
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takes a lot from the government
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she may not even send a qualified nurse
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and chances are good she won't even show
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up next week
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that kind of scam can be really tempting
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she's offering something you'd like to
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have
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other people take the scam even
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further some drive a medical van around
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offering to do medical tests you don't
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need just so they can bill medicare for
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them
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in idaho seniors were rounded up and
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taken on a trip to las vegas then
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medicare was billed for a week of
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medical supervision
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it's not enough to turn down an offer
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like this you also need to report it so
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the medicare abuse can be stopped
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now i've put the odds in your favor
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you've seen how important it is to
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protect your card and keep your medicare
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number out of the wrong hands
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when medicare is ripped off people who
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rely on the program and deserve its
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benefits are the ones at risk
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more than 42 million people in fact
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here's what you've learned and what you
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should tell your friends
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medicare doesn't make cold calls
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medicare doesn't go door-to-door
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and medicare doesn't offer free services
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but they do
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you can avoid being a victim of fraud
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remember to protect detect and report
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protect your medicare number as you
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would your bank account number or a
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credit card
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detect fraudulent scams by knowing what
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medicare does and doesn't cover and
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report suspicious behavior
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protect
11:08
detect report
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if you suspect you've been a victim of
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medicare fraud or would like to learn
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more about avoiding and preventing
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health care fraud contact your local smp
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program
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for more information about new hampshire
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smp contact service link call us
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toll-free at 866-634-9400
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or visit us online at
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www.servicelink.org
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so anytime you receive a phone call or
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door-to-door visits asking for your
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medicare number be suspicious be
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cautious about giving your personal
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information
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and if you did get a call or a visit
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like the ones you just saw give service
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link a call to let us know
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not every case is fraud sometimes
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medicare is billed incorrectly it's not
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intentional it's a mistake
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but it's important to keep an eye on
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your medicare summary notices to be sure
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mistakes are caught and corrected if
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they happen to your medicare number
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thanks carol
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the video introduced us to the three key
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words of steps that s p wants everyone
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to remember protect detect and report
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becky will you talk to us a little bit
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about
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more about the importance of protecting
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our personal information and some tips
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for doing that sure paul
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well the best way to protect yourself
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from becoming a victim of health care
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fraud is to learn more about it and then
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take some simple steps to protect
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yourself
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one very important thing that we tell
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people is to treat their medicare card
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like a credit card or a bank card
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keep it in a safe place and don't carry
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it in your wallet or purse unless you
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need it
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only take it to doctors appointments
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visits to your hospital or clinic or
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trips to the pharmacy
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don't give out your medicare number
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except to your doctor or other medicare
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provider
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never give it to a stranger
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another reason to protect your medicare
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card is because it could also be your
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social security number
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so someone who steals your medicare
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number also has your social security
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number and can steal your identity
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it's also a good idea to keep a record
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of your doctor visits and other medical
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treatments so you can check it against
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the charges on your medicare summary
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notice
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this can often uncover inappropriate
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charges or billing mistakes
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and shred old bills and summary notices
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that you no longer need so that your
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information isn't readily available for
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someone to pick up and use
13:47
thanks becky
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so it's important to protect your
13:50
medicare card and number now what about
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ways to detect possible problems in your
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medicare account
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carol mentioned earlier the medicare
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summary notice so i'll ask her to tell
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us what that is and what you should be
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looking for when it comes in the mail
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sure paul
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if you are already on medicare you
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probably are familiar with your medicare
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summary notice sometimes it's called an
14:14
msn
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it's not a bill it's a notice that
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people with original medicare get in the
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mail every three months
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for their medicare part a and part b
14:26
covered services
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the medicare summary notice shows all
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your services or supplies that providers
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and suppliers billed to medicare during
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the three-month period what medicare
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paid and the maximum amount you may owe
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the provider
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if you didn't get any services or
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supplies
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during a three-month period you won't
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get a medicare summary notice in the
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mail
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for that particular three-month period
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when you do get a medicare summary
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notice in the mail you should check for
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three things
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first
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check for charges for something you
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didn't receive
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second
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check for billing for the same thing
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twice
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and third
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check for services that were not ordered
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by your doctor
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as becky mentioned previously it's a
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good idea to keep your own record of
15:23
your doctor visits and medical services
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you can put it on a calendar or in a
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notebook or we have a personal health
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record that is available for you at
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service link
15:36
then you can compare your own record to
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what you see on your medicare summary
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notice
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if you see charges that you don't
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understand
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or services that you didn't receive
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it could mean that there's been a
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billing mistake
15:51
or that someone is using your medicare
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number to bill inappropriately
15:57
i have an example
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there was a lady who received her
16:02
hospital bill
16:03
and she had been to the hospital and had
16:05
a hip replacement the bill was for
16:08
speech therapy and she brought it to
16:10
service link it was in rockingham county
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and they investigated and corrected the
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bill and corrected her medicare summary
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notice
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so we've talked about ways to protect
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ourselves and what to look for to detect
16:25
possible fraud or mistakes
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that brings us the last key step to
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report your observations or concerns
16:33
becky can you tell us how people can
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report something that doesn't seem right
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and what they can expect when they do
16:40
sure paul
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one thing people can do if they have a
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question about a charge from their
16:45
doctor or another medical provider that
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they don't understand is to call the
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provider's office and ask them about it
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often if it's a mistake one call can
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take care of it
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but sometimes people aren't comfortable
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in calling a provider's office
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they might feel embarrassed or anxious
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about it
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so we want people to know that they can
17:06
always get personal assistance through
17:08
the smp program at their local service
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link resource center
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we'll listen to your questions and
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concerns and help get issues resolved
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we can go over your statements and
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summary notices with you if needed
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and if a problem is spotted that needs
17:25
more review we'll help by referring it
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to the proper medicare office for
17:30
additional review
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and our services are always free and
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confidential
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we hope you'll remember that s p
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services are a part of medicare
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assistance and that is available to you
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and all people throughout new hampshire
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through the service link resource
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centers located in every county
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our specifically trained smp staff and
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volunteers provide outreach and
17:53
education in communities throughout the
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state
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as well as meet with individuals
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whenever they see or experience
18:00
something that doesn't seem right
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and in doing so they not only protect
18:04
all the persons but they help stop the
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large losses to the medicare and
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medicaid programs and preserve them for
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the future
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like smp programs all across the country
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new hampshire smp depends on volunteers
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to help with outreach and educational
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programs in the community
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and i'll let carol
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talk about volunteer opportunities yes
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thanks paul service link depends on
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their trained staff
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and smp volunteers to help provide
18:34
information about health care fraud and
18:36
abuse throughout our state
18:39
some volunteers enjoy helping with group
18:42
presentations
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others assist with smp displays at
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community events
18:48
some volunteers may be interested in
18:50
providing that one-on-one counseling
18:53
to medicare beneficiaries or offering
18:56
administrative help in the service link
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offices
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whatever their role
19:01
s p volunteers are a valued member of
19:04
the service link team
19:06
they receive training and support for
19:08
their role and enjoy
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meeting working with and helping many
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people
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often they are retired and medicare
19:17
beneficiaries themselves
19:19
so they are really a good fit for
19:21
working with their peers
19:23
if you are interested in learning more
19:25
about our volunteer opportunities please
19:29
contact your local service link the
19:31
toll-free number on the screen will
19:32
connect you to the service link resource
19:34
center in your area so give us a call
19:37
i'd like to thank becky rostrom
19:40
and carol german for joining me today to
19:43
talk about medicare fraud and abuse and
19:45
the senior medicare patrol or smp
19:47
program and thanks to all of you for
19:50
watching
19:51
remember that for all your medicare
19:53
questions service link is just a phone
19:55
call away
19:56
call us for information about any of our
19:58
services or to find out about our
20:01
volunteer opportunities
20:02
we're happy to hear from you
20:07
so be smart protect your identity and
20:10
your medicare benefits
20:12
by treating your medicare and other
20:14
health insurance cards in the same way
20:17
you would protect your credit cards
20:20
only giving personal information to
20:23
medicare approved doctors providers and
20:25
suppliers
20:27
social security
20:29
or the medicare staff at service link
20:33
shredding papers with your personal
20:35
information before putting them in the
20:37
trash
20:40
avoiding free offers in exchange for
20:43
your medicare number
20:44
[Music]
20:46
and reviewing your medicare summary
20:48
notices and other statements and medical
20:51
bills for any charges that seem
20:53
suspicious or incorrect
20:56
and remember for all your medicare
20:58
questions
20:59
call your local service link resource
21:01
center
21:03
the toll-free number on the screen will
21:05
automatically connect you to the service
21:07
link in your area
21:11
[Music]
