Frequently Asked Questions

About Medicare Fraud

Call 1-800-Medicare (1-800-633-4227). Note: 1-800-Medicare WILL ask for your Medicare number.

Contact your local State Health Insurance Assistance Program (SHIP).
SHIP Locator: https://www.shiphelp.org/about-medicare/regional-ship-location
1-877-839-2675

Follow the “Process of Investigating” steps outlined in the section below.

Alert your health care providers so they can be aware of suspicious activity. Stay vigilant about reviewing your statements. If you notice anything suspicious contact your health plan or provider and ask for a correction. And please Contact Us, Delaware Senior Medicare Patrol (DE SMP) to make a report or simply to assist you along the way.

Report it! See the Find Help page of this website. 

Visit our Detect page for tips on fighting fraud in the moment, as well as our common frauds to know. 

We encourage you to report suspicious activity to The Federal Trade Commission (FTC) at 877-382-4357 or online at www.ftccomplaintassistant.gov., as well as to your local law enforcement. 

Contact your state’s Quality Improvement Organization (QIO). QIOs investigate these complaints, gather facts from all parties involved, and recommend action to help providers and suppliers improve quality of care. To locate your state’s QIO, visit www.qioprogram.org/locate-your-qio. 

The Process of Investigating

How do I know if something is legitimate? Here are steps we recommend you take to investigate any concerns:

Step 1: Contact that Provider or Supplier 

Call your health care provider or supplier first to question the charge.

If the issue is determined to be a mistake, ask them to correct it.

Step 2: Contact The Payer/Insurance

If the provider or supplier can’t answer the question, contact the company that paid the bill. Their contact information can be found on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB).

Step 3: Contact DE SMP

If the issue still isn’t resolved, Contact Us, DE SMP, and we can assist. If fraud or abuse is suspected, we will guide you in resolving it and we will refer cases to the proper authorities on your behalf.

About Senior Medicare Patrols