Local woman finds Medicare fraud is a reality here

Published 3:57 am Sunday, April 2, 2000

By By Sherry Digmon
Advance Staff Writer
Loraine Byrd has never been transported by an ambulance in Illinois. Nor has the Atmore woman ever been treated by doctors in Illinois.
But last year, Medicare was billed n and paid out n thousands of dollars for those "charges" incurred in Illinois.
He supposedly treated Byrd for her hospital stay in Marion several days last July.
Byrd called a phone number on the statement, and told the Medicare representative about the erroneous charges.
She was finally connected with Deborah Dennis in Medicare's Benefits Integrity department, a federal agency, who told Byrd her department would investigate.
A day or two later, Byrd got a another statement. This one was from Dr. Johnstone in Marion. It was the first of three statements she received for his services.
With the ambulance service and both doctors, the total billed to Medicare was in the thousands.
Following the investigation by Benefits Integrity, Byrd received a letter from Dennis informing her that the doctors had reimbursed Medicare.
Byrd feels sure the erroneous charges came out of a Pensacola medical facility.
Her sister, who lives in Orange Beach, was treated at the center about the same time. She received a statement from Medicare for treatment by a doctor in Gainesville. Byrd's sister got contacted Gwen Gay who got in touch with Byrd.
Gay is with the Senior Medicare Patrol Project, Area Agency on Aging. The agency is part of South Alabama Regional Planning Commission.
Gay was not surprised at those reports.
Her agency is on patrol n against billing errors, improper billing (billing at a higher rate for Medicare patients), Medicare abuse and fraud.
The goals of the Medicare patrol project are to encourage Medicare recipients to review their Medicare statements, as Byrd did, and to form a network of volunteers to help recipients who might need assistance reviewing their statements.
Gay stressed that not all errors are attempted fraud. Many are simply human error.
The biggest question Medicare recipients need to answer, Gay said, is "Did I get these services from this provider at this location?"
Volunteers will be able to help Medicare patients answer that question.
Escambia County is one of only 18 counties in the state to participate in the project.

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