S.O.R.T. Program
Preventing
Healthcare Fraud
and Abuse
Each year, fraud and abuse costs the Medicare and Medicaid programs billions of dollars. Some fear that this could put the future of these programs in danger. Consumers are critical in the fight to prevent fraud and abuse in the Medicare and Medicaid programs.
The S.O.R.T. (Senior Organized to Restore Trust) uses volunteers to fight fraud and abuse through public education and individual billing reviews. Comprised of trained volunteers, primarily retired professionals, the program has made headway in reducing fraud and abuse in Missouri.
S.O.R.T specialists are trained on Medicare, Medicaid, supplemental insurance and health care fraud and abuse. These volunteers can review Medicare summary notices to help identify billing issues and provide assistance in reporting any problems. This assistance is available free of charge.
What happens if I call the S.O.R.T. Program?
Your question or concern is referred to a S.O.R.T. specialist in your community. This volunteer will work with you to resolve your complaint. If fraud or abuse is suspected, the case is referred to the appropriate investigative agency for further review. Privacy and confidentiality are strictly maintained.
Tips to prevent fraud
- Don't ever give out your Medicare number (on your Medicare card) except to your doctor or other Medicare providers.
- Don't allow anyone, except appropriate medical professionals, to review your medical records or recommended services.
- Be careful in accepting Medicare services that are represented as being free.
- Be cautious when you are offered free testing or screening in exchange for your Medicare card number.
- Be cautious of any provider who maintains they have been endorsed by the Federal government or by Medicare.
How you can make a difference
- Be informed about Medicare benefits.
- Know the type, frequency and quality of care being provided to you.
- Know the services your doctor has ordered.
- Ask questions about the services you receive.
- Report concerns. You may make a confidential report to the S.O.R.T. program. Please be assured that Medicare is very interested in any information you provide and will give your report of suspected fraud or abuse serious attention. Call the toll-free S.O.R.T. line at 888-515-6565.
- Volunteer to be a S.O.R.T. specialist. Your increased knowledge could help others in your community.
More information
Contact Mary Karch at mkarch@marc.org or 816/421-4980.