Kitty discusses Medicare fraud, what it is, what to look for and how to report it through the MMAP Senior Medicare Patrol.
Brooke interviews Sandcastle Adult Day Care Coordinator Heather Love and discusses how caregivers can take advantage of this wonderful respite service.
Kitty discusses Medicare fraud, what it is, what to look for and how to report it through the MMAP Senior Medicare Patrol.
Brooke interviews Sandcastle Adult Day Care Coordinator Heather Love and discusses how caregivers can take advantage of this wonderful respite service.
Good morning. This is Kitty Glomski along
Brooke Mainville:with
Brooke:my cohost Brooke Mainville
Kitty Glomski:from Region 9 Area Agency and Aging and another episode of Let's Talk About Aging. This is Kitty Glomski with a segment that we call Scam Alert. In today's segment, I'm going talk about what you can do to prevent healthcare fraud. This is an important topic. What is Medicare abuse? It's defined as incidents or practices of providers that are inconsistent with accepted, sound medical business, and fiscal practices. Every year, there's 65 billion that's billion with a B a year in Medicare fraud. That's money that should stay in Medicare for all of you. Examples of fraud and abuse would include things like: billing for services, supplies, and equipment that are not provided, billing for excessive medical supplies, obtaining a Medicare number for free services, improper coding to get a higher level of payment, unneeded or excessive x-rays and lab tests, claims for services that are not medically necessary, and using another person's Medicare card to obtain medical care, supplies, or equipment. The list just goes on and on. Medicare fraud is intentionally billing Medicare for services that were not received, or billing for a service at a higher rate than is what is actually justified. Who does this? It can be any person or business in a position to bill Medicare or to benefit from what Medicare's being billed for. This could include doctors, healthcare practitioners, suppliers of durable medical equipment, employees of physicians or suppliers, employees of companies that manage Medicare billing and other beneficiaries. It can be perpetrated by just about anyone. There are billions of dollars lost every year. And the effect is that your healthcare services may be affected. Those are taxpayer dollars that are being wasted and it puts the Medicare trust fund at risk. So there's three steps that we can use to prevent Medicare fraud. Protect, detect, and then report. Step one: treat your Medicare card like credit cards, protect them and watch out for identity theft. Be aware that Medicare does not call or visit you to sell you anything. Don't give out your Medicare number except to a doctor or a Medicare provider for services rendered. And don't carry your Medicare card with you unless you need it. Number two: detect Medicare fraud and abuse. Use your personal healthcare journal to document your doctor visits and check it against your billings, your Medicare summary notice that you get along with your statements, look for services that you didn't receive. Anything that may be double billed or services not ordered by your doctor. Access to your Medicare information can be found when you set up an account at www.myMedicare.gov. Step three: report suspected Medicare fraud and abuse. Call the provider. If you get a bill and it doesn't look right, then call your doctor and ask about the billing, gather information and documentation, and then contact us. We're MMAP(Medicare Medicaid Assistance Program.) We have a toll free number in the State of Michigan. That toll free number is 1-800-803-7174. This is a free and confidential service. What is MMAP? MMAP offers free, confidential, healthcare insurance counseling and assistance for people with Medicare. We are members of the Senior Medicare Patrol and work to stop Medicare fraud. So if you suspect that you've been involved or you've seen, or, you know of a case of suspected fraud or abuse,call us at 1-800-803-7174. This is Kitty Glomski. Check back with us for our next scam alert.
Brooke Mainville:This is Brooke Mainville, special coordinator for Region 9 and I have a special guest with me today. Heather Love is the Sandcastle coordinator for the Adult Day Center in Cheboygan. Welcome, Heather. So Heather for our viewers that might not know what an adult day center is what is an Adult Day Center?
Heather Emerick:Thank you. We bring in elder adults to our program each day, we pick them up in the morning. An Adult Day Center, it's more or less a respite for their caregivers.
Brooke Mainville:So who's able to come to the Adult Day Center?
Heather Emerick:Seniors.
Brooke Mainville:And is it also for people 18 that have special needs? Yes, we do have a couple special needs that are 18 and older as well. So you said that you actually pick'em up here?
Heather Emerick:We pick'em up at their homes or wherever they may be. We have a couple clients that we pick up at other places; might be a parent's work or maybe an adult foster care, but we do pick them up.
Brooke Mainville:That's amazing for family caregivers that are taking care of someone, it allows them time by themselves at their own home instead of having to leave their home within home respite.
Heather Emerick:Absolutely. It is a great program, and we have gotten more and more clients in the last three months. It's definitely a need in the community.
Brooke Mainville:Have you seen a change in a caregiver from the beginning when their person comes?
Heather Emerick:Yes, absolutely. When they first come they are really at their wits. They really need the help for sure. Then when they come here, give them a month and they're way calm, way better. A lot better.
Brooke Mainville:We have a total of six adult days in our region. So we have Alcona, Arenac, Cheboygan, Ogemaw, Otsego, and Rosscommon, and they all act differently. So we're talking here with Cheboygan. So Heather, What is the cost, and how does someone register to come to the program?
Heather Emerick:They would need to call our main number for the Cheboygan Senior Center. Then they would get with my boss Teresa, who has many hats that she wears, she would set up an appointment, and there is an assessment that they need to go through to make sure that we are qualified to take care of their loved one. Their phone number is 231-627-7234
Brooke Mainville:That is the phone number that you would call and then your address, you are on Sand Road in Cheboygan, correct?
Heather Emerick:We're 1531 Sand Road.
Brooke Mainville:Then does the cost vary? How does that work?
Heather Emerick:Well that depends, we do have funding, it varies from their income, and there is a sliding scale. Absolutely.
Brooke Mainville:Perfect. Let's say I want to bring my grandma or whoever here. What kind of activities would you do with her?
Heather Emerick:We have a lot of activities. We do some outings a couple times a month, like the fairs coming up. We would take them to the fair and see all the animals. We've taken them to a fish hatchery in Alanson. Mainly they like to stay here and socialize. We'll all sit at a table and we'll play games, or I might break a couple of'em off and do a craft. They really like UNO. They love bingo. So there's some special games that they really like to do. Monday, we have Zumba and that starts at 9:00, Tuesday and Thursday, we have chair exercise, and on Wednesday, I'll start a craft, we have the chair yoga or the chair exercise Wednesday and Friday we're on our own in Sand Castles; the Senior Center is closed. We do crafts, UNO, bingo games. They could watch TV. We could sit outside.
Brooke Mainville:Do you guys provide any personal care?
Heather Emerick:We do have a bathroom within Sand Castles. So we would give a shower. We also have a registered nurse that does toe care once a week, so they could do that, and I've also done hair. Like if they needed me to wash their hair and set it we've also done that as a service.
Brooke Mainville:It's about getting them out, being social, giving them a purpose while the caregiver is at home or grocery shopping, has a doctor's appointment. What are your hours at this center?
Heather Emerick:So we are Monday through Friday, 8:00 to 2:30.
Brooke Mainville:That's good, and some people can bring them, I mean, anyone can bring them every day, Monday through Friday,
Heather Emerick:Monday through Friday. We have some that drop off. We have some that we pick up.
Brooke Mainville:And what about meals?
Heather Emerick:Yep. We, we give them a snack in the morning when they get here. I have a whole variety of different snacks, different healthy ones. Then they'll have their coffee or tea. And then we have a meal, a lunch that we provide for them, a salad bar and a meal. Today they are having club salad.
Brooke Mainville:Delicious. Honestly for the caregiver, they know their care recipient is receiving a meal, activity, socializing, they're safe, so that they can go home and take care of themselves for that little bit to avoid caregiver burnout. That's amazing.
Heather Emerick:Five days a week, six hours a day.
Brooke Mainville:I think we covered the whole spectrum in that little bit of time. So if you're a caregiver that needs some services, definitely reach out. Thank you so much, Heather, for being here. We do appreciate it and I'm sure we'll have you back in the future.
Heather Emerick:Yeah. Thank you so much.
Brooke Mainville:This is Kitty Glomski and Brooke Mainville, with the Calendar of Events for August. Brooke, tell us what you've got.
Brooke:I have a full calendar for everyone. We have a virtual Creating Confident Caregivers starting August 2nd going to September 13th. That's at 10:00 AM to noon. Creating Confident Caregivers is for dementia caregivers. We have a PATH for Chronic Pain. That's virtual starting August 26th and going to September 30th, from 1:00 to 3:00. If you're dealing with chronic pain issues, this is a workshop for you. We have a Matter of Balance that's in person up in Cheboygan. So Matter of Balance is a fall prevention workshop, and we talk about how to modify your house, how to talk to your doctors and family about falls, how to exercise so you maintain your mobility. That is in Cheboygan, August 3rd to September 21st from 9:30 to 11:30. We have some webinars that are taking place. Our first one is going to be August 12th and that is Navigating Family Dynamics and Caregiving. Dealing with a care recipient maybe isn't hard, but then you have your family, maybe the different dynamics involved with that is hard. So how do we go about navigating that? Navigating Family Dynamics and Caregiving is taking place August 12th from 1:00 to 2:00. Then on Friday, August 19th, we have a Healthy Living Webinar and that is Living With Chronic Pain. It's taking place Friday, August 19th from 1:00 to 2:00, it's Living with Chronic Pain., and this one is only a one-hour session. If you're able to do the six-week chronic pain PATH workshop, that's taking place August 26th. To register for the workshop, please contact me at 989-358-4616 again, that was 989-358-4616. Or go to our website at NEMCSA.org/ senior services, and you'll find all the online registrations for all the different items there as well. That's all I have for the calendar events. So I have two virtual workshops, one workshop in person in Cheboygan and two virtual webinars.
Kitty Glomski:Thank you, Brooke. With the Medicare Medicaid Assistance Program, we also have a New to Medicare virtual presentation on the second Wednesday and this is for anybody that is new to Medicare. If they're planning their retirement and they want to know how Medicare handles their benefits, or if you're disabled in starting Medicare, this presentation explains how Medicare works. Then afterwards you get to meet one on one with a counselor and talk about your personal situation. To register, you can call 1-800-803-7174 or contact your local senior center, your Commission or Council on Aging, and they can make the appointment for you. So this is Kitty Glomski and Brooke Mainville asking you to join us again next time on Let's Talk About Aging.
Carla:Let's Talk About Aging is a production of the Region 9 Area Agency on Aging, 2569 U.S. 23 South, Alpena, Michigan 49707. This Podcast was supported, in part, by grant number 90MPPG0039 from the US Administration for Community Living, Department of Health and Human Services, Washington, DC. Podcast music provided by Groove Music, selection titled"Modern Logo," created by Vadym Kuznietsov and can be found at https://elements.envato.com/modern-logo-ZVHFBJ6