Volume 28 No. 8

Medical Staff Update Top Story:

Medicare warns of provider scam

SHC medical staff members may be vulnerable to scam artists who would fraudulently secure their personal and business information to make false Medicare claims.

Physicians who receive calls from persons purporting to be employees of Medicare or National Heritage Insurance Co. [NHIC] are urged to report fraudulent or suspicious calls to SHC personnel and to Medicare, said Michele Kelly, manager of Community Relations for Medicare in Los Angeles.

Kelly said a significant number of callers in Southern California have recently represented themselves as working for either Medicare or NHIC. The scam artists then use the physician information they collect to submit fraudulent Medicare claims.

"Although you may receive legitimate calls from our office requesting information, if you have any questions or concerns about the person contacting you for information either by telephone or in writing, there are several things you can do," Kelly said.

The steps are:

Ask for the caller's phone number and call them back to confirm who they are. If they give a badge number, be aware that NHIC employees do not have badges.

Obtain the control number for the information being requested, and call Medicare at (847) 591-1587 to verify the request.

If the request is in writing, make sure it is on a letterhead. Compare the letterhead to the Medicare letterhead used for previous inquiries.

SHC physicians who receive fraudulent or suspicious calls should contact Margaret Boggs, director of professional service operations at Stanford at (650) 498-5701, fax 498-5840, or Physicians are also encouraged to report the incident to Medicare at (877) 591-1587.


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