As more senior citizens begin a Medicare journey necessitated by the ravishes of aging and illness, educating seniors on how to understand Medicare summaries, pamphlets, annual guide books, and a whole host of other health care documents is also necessary. Add to this the threat of fraud, identification theft, and plain old ordinary clerical errors, well it’s a lot to take in. But help is available.
Most councils on aging offer annual Medicare workshops, and Medicare also has layers of services available online. But what if something goes wrong and you need help untangling a billing problem on your account – enter Senior Medicare Patrol.
On September 2, Mattapoisett’s Council on Aging hosted a remote presentation featuring Dennis Hohengasser of the SMP. Established in 1997, this watchdog group works to protect, detect, and report health care fraud and to provide assistance with claims resolution when things go wrong.
Hohengasser stressed the importance of reading Medicare summary statements to ensure that services that were paid on your behalf were correct. Fraud, waste, abuse, and errors in Medicare billing amounts to a mind-blowing $60,000,000,000 every year, 10 percent of the estimated $600,000,000,000 spent on Medicare services.
Seniors, Hohengasser stressed, are the first line of defense against taxpayer’s dollars being stolen or wasted. He said that Medicare statements should be thoroughly reviewed and saved for up to two years. He cautioned that when services are inappropriately billed to an account, the patient may be denied treatment or services in the future. He used the example of a one-time medical procedure being billed to an account when it never took place. Subsequently, when the real claimant needed that service, they were denied because it appeared in records that they had already received the procedure. “It can take months to clear up a problem,” he said so it’s important to take action.
Hohengasser also discussed the importance of protecting one’s Medicare card. He said it is not necessary to carry it with you at all times. Identification theft as well as scams can cost the system hundreds of thousands of dollars, and the claimant months of agony trying to correct matters. “Never give out your Medicare or Social Security numbers over the phone or online,” he pleaded.
On the topic of record-keeping, Hohengasser promoted the use of a health care journal, a small diary where one can keep track of medications, treatments, and procedures, as well as questions for the doctor and the doctor’s answer. He also pointed to the importance of asking your doctor questions. “Ask the doctor, ‘Do I really need this test or procedure, what are the risks, is there a simpler option, what if I do nothing, what’s the cost.’”
Reporting of subpar care was another topic touched on by Hohengasser. He told the story of his aunt who was admitted into a rehabilitation facility. She experienced stomach pain that was treated as if it were simple constipation. After two days she called an ambulance to the facility and had herself taken to the emergency room. She was suffering from a serious colon condition. If poor quality care either in the home or in a facility is an issue, the organization to contact is Kepro, a quality-assurance contractor for Medicare reachable at 888-319-8452. You may also contact Medicare’s Senior Medicare Patrol at medicareoutreach.org. A video of Hohengasser’s presentation and two other related videos are available at orctv.org.
Earlier in the day, the Mattapoisett COA board of directors met. The monthly meeting covered repairs to the COA van in the sum of $1,600 and grants being used to provide more movement classes.
On the issue of bringing programming back inside for the winter, COA Director Jackie Coucci said, “I don’t know what to say about that at this time.” She said she had discussed the possibility of using the Congregational Church hall, given its spacious interior, but needed to work with the Board of Health and town administrator. Coucci said that pandemic guidelines will most likely restrict the number of participants to any given activity. She also said she personally is not in favor of reopening the spaces used for the COA at Center School yet, saying, “Just because we can doesn’t mean we should.” However, she also asked the board to vote on whether or not she should move forward pursuing that option. The board moved to have Coucci begin those discussions and return to the October meeting with a plan.
Shirley Haley, board vice chairman, brought the group up-to-date on the recent Master Plan workshops. She said it is important for everyone to complete the online survey in order to give voice to their thoughts and ideas. The survey can be found at mattapoisett.net.
Coucci said that the COA continues to provide a variety of services from rides to medical appointments and grocery shopping, to podiatrist services, distribution of medical equipment, legal and financial counseling, and friendly caller outreach. “In spite of the closure we are still servicing the community,” she said.
The next meeting of the Mattapoisett COA is scheduled for Wednesday, October 7, at 8:30 am. Remote details will be available at mattapoisett.net.
Mattapoisett Council on Aging
By Marilou Newell