MMAP Counselor Shelly Olree discusses situations where she's helped clients in Montmorency County with scams and fraud. Shelly works through the five clinics with Thunder Bay Health Centers.
MMAP Counselor Shelly Olree discusses situations where she's helped clients in Montmorency County with scams and fraud. Shelly works through the five clinics with Thunder Bay Health Centers.
Good morning. This is Kitty Glomski along with
Kitty Glomski:my cohost Brooke Mainville from Region 9 Area Agency and Aging and another episode of Let's Talk About Aging. This is Kitty, and I'm here today with Shelly Olree from the Thunder Bay Community Health Center. Good morning.
Shelly Olree:Good morning, Kitty.
Kitty Glomski:Can you tell us a little bit about the Community Health Center and your role there, because you are a MMAP counselor aren't you?
Shelly Olree:I am employed by Thunder Bay Community Health Services. My home site is at the Hillman location, but I cover all of our five main clinics which would be in HiIlman, Onaway, Atlanta, Rogers City, and Fairview. I am a MMAP counselor and am always willing to assist with helping guide our people through the process of enrolling and comparing plans and such.
Kitty Glomski:That's a pretty big role. You said you are in five different clinics, is that correct?
Shelly Olree:Yes. Where there's a need, that's where I go. I'm the only MMAP counselor for Thunder Bay at this time.
Kitty Glomski:And MMAP, we call it MMAP, is actually Medicare Medicaid Assistance Program. So that means you are helping folks with anything Medicare related, and if they need assistance applying for Medicaid, you are the person, right?
Shelly Olree:Correct. I'm considered a community partner with MDHHS, Michigan Department of Health and Human Services.
Kitty Glomski:Our mission as far as MMAP goes is to help people that are age 60 or older, or those that have Medicare under that age. So Medicare is the priority, and community partners can help who?
Shelly Olree:They can help anybody that has a need even outside of insurance enrollment. So it could be help with past due utility bills or connecting them with food pantries in the area. Anything, in any way I can connect a person with community resources is the main goal of my job.
Kitty Glomski:So our training as far as MMAP goes is connected with Medicare, and of course we also receive Medicaid training. But your scope is so much broader, so you are in very high demand, aren't you?
Shelly Olree:It keeps me very busy. It's a very fulfilling position. I enjoy what I do.
Kitty Glomski:I have a true appreciation for the fact that you are helping in five communities, and that's pretty rare in our network. So thank you for your service because it's needed. Today we want to talk about scams and fraud in the area because there's a few things popping up recently and we want to make everybody aware of what's happening. So what have you come across as far as current scams?
Shelly Olree:One that I recall was a husband, wife couple. The husband was dealing with some dementia issues and would readily pick up the telephone call and carry on a conversation with whomever on a phone call. This gentleman was talked into ordering a back support belt and stating that his Medicare would be billed for it and it was going to be free to him. And of course, even if Medicare was billed for it without any kind of documentation from a physician, we know that Medicare was probably going to deny that and then the patient would end up getting billed. So a lot of the durable medical equipment scams where they think that they're being helped and they're getting an item that's going to be covered by their insurance. And when it's not and they get the bill, often times I'm afraid people just pay the bill. It's unfortunate that it's not questioned and stopped before that even happens.
Kitty Glomski:Medicare fraud and scams; this is over a$60 billion business: that's 60 with a B billion and what they're doing is calling Medicare beneficiaries and talking them into giving either a Social Security number or their Medicare number, and then they bill all kinds of stuff. There's something that people can do to detect it, and it's called the Explanation of Benefits. You want to talk about that?
Shelly Olree:The Explanation of Benefits is a great aid to make sure that your services are being billed correctly and that they're being paid for correctly. I sat down with a beneficiary just two days ago who had several bills that she needed assistance with, and one of them, it didn't even appear that it was a service that she had. It didn't even appear that her Medicare was even billed for it. She was willing to pay full payment when I could readily see that it didn't appear that Medicare had even been billed for it.
Kitty Glomski:The explanation of benefits
Shelly Olree:Is a good tool to make sure that the services that they had are actually being billed or being billed correctly. On the other end of the spectrum there's things that are on there that may not have been a service that they could have been billed for it, that fraud happens as well.
Kitty Glomski:The explanation of benefits will list every single transaction that has been billed from every single provider when a provider is your doctor or the clinic or whoever. And so it's important to read these, isn't it? Because if there's something on there that you think, oh my, I, I don't know this person I didn't receive this service, then what should they do, Shelly?
Shelly Olree:They should call the physician's office or the facility that actually billed for that service to question what is showing up on that explanation of benefits because it may have been billed in error. But the first step is to go to the facility that actually billed for that service.
Kitty Glomski:So if we have a scammer that bills durable medical equipment, like a neck or back brace or something like that they can call a MMAP counselor can't they?
Shelly Olree:Absolutely.
Kitty Glomski:Yes. We have a direct line to Medicare if need be and we report these things. But a lot of times it's just determining what it is that's actually getting billed and did they actually get the item? That's one of the scams. One that's popped up recently that has been around in our area for a while. They call it the grandparents scam. And have you received any of those, Shelly?
Shelly Olree:I have not.
Kitty Glomski:The way this unfolds is that you get a phone call and they'll acknowledge and say,"grandma, I've been in an accident, and I need your help." I need plane fare or I need to pay a court cost or whatever it is. Grandma or grandpa assumes because they can't usually hear real well, they can't determine who's on the other end of the phone and they end up sending them money. Lately the scammer will stay on a cell phone with them to their bank and tell them what to do and what to say and how to do it, and put it on a gift card. And once that money, the gift card is given to the scammer, that money's gone. So what advice would you give anybody that receives calls asking for money, asking for banking information, Medicare numbers, Social Security numbers, driver's license? What kind of advice can you give our beneficiaries.
Shelly Olree:Just say no. That gets really tricky because the trickster are on the other end of the phone can be very convincing, but obviously not giving out any personal information, knowing that Social Security is never gonna call you and ask you for your Medicare number. They're not gonna ever call you and ask for your Social Security number. Anybody that would call and ask for specific personal information should be red flagged as a potential scam.
Kitty Glomski:Absolutely. In fact yesterday I had a client call me that had received a phone call telling them that their credit card didn't record the payment, the premium payment, the monthly premium, and they called me. What we did was to see, number one, if the bank was recognizing that they had a payment due and it wasn't. Come to find out this gentleman had a new card come. It was the same number, but it had a different expiration date. So we called his insurance company direct and talked to the billing department and gave that update. But anybody that asks for credit card, banking, just hang up the phone, call us, call one of us if they're asking for Social Security or Medicare numbers, they shouldn't be because Medicare and Social Security already know who you are. They have those numbers. They don't need to call you and ask. They have those numbers.
Shelly Olree:I have a really interesting situation that happens to be a Medicare beneficiary that I am assisting. She came to me this week with a several page letter from the IRS. She's very low income. She's fixed income. She doesn't even file a federal income tax return.
Kitty Glomski:That should have been suspicious right away, right?
Shelly Olree:Absolutely. And it has to do with a federal fuel credit of$21,000. The IRS is claiming that she wasn't eligible for that credit, and they want her to pay the balance of whomever turned in the receipts that would've reconciled with that credit. There was a balance left on that and they want her to pay for that. Obviously I, I helped her, and filling out the paperwork to say that we dispute what they're saying. I called the IRS general helpline. We couldn't share personal information, but when I explained to her what was going on, she said something definitely is not right. Those federal fuel credits require lots of paperwork to fill out. It's not just a checkbox that somebody did. I'm concerned somebody has her social security number and we're actually meeting today. When I dug into it a little bit, there is actually a federal fuel credit scam that has been going on for a couple years that these people are getting these fuel credits on somebody else's social security card.
Kitty Glomski:Wow. Protect your cards. Don't accept phone calls. If you don't know who they are, just hang up the phone. If it's important, people will leave a message for you and if you have any questions, our network, Medicare, Medicaid Assistance P rogram network. We are also part of what they call Senior Medicare Patrol. That is special training that we have to report scams and fraud and we go right straight to Medicare to do it. So tell us about this, use our 800 and that's 800-803-7174. You can talk to a MMAP counselor and tell them what's happened. But the big thing is people on the phone, they're not your friends. You don't know them. Hang up the phone. Don't answer the phone if you don't recognize the number. If it's important, they'll leave a message or they will send you a letter in follow up. Not all mail is good to go either. Is it Shelly?
Shelly Olree:Right. Well, I did let this beneficiary know that the I R S would be calling her, but I made it very clear that they will give you an ID number and make sure you write down that ID number, that they give you when they call, and that they will not ask for your personal information.
Kitty Glomski:Right. They'll have a case number. So to be honest, my family received an IRS phone call. And told my spouse that we had taxes due. And my husband called me at work and said, didn't we pay our taxes? And I said, I hope you didn't give out anything because that's a scam. I'm a MMAP counselor remember? So just hang up the phone and it was so convincing. It was really scary. If you looking at how scams work, they want to scare you. They want you to seem like you're really in big trouble, and you need to act right now. There's an immediacy to it and they know how to talk and they know how to play. Just hang up the phone. Call one of us 800-803-7174. There's one of us there to help you. So even if it's just to talk and ask a question. We are here to help. So sometimes you need to also look at any paperwork you get. It's not all scams and fraud, but we want to correct mistakes and get things squared away. And if you don't know, ask us. We're here to help, aren't we?
Shelly Olree:Absolutely. I love problem solving. I like to dig in and problem solve. So if a beneficiary is not sure how to go about getting resolution with something that could have been billed erroneously or fraudulently that's what we're here to do.
Kitty Glomski:Right. So Shelley, you're serving Montmorency County. Are people able to call you direct?
Shelly Olree:They can call any of our Thunder Bay Clinics and ask for Shelly regarding insurance or resources, and all of our clinics know how to forward that call to me directly.
Kitty Glomski:What's your number?
Shelly Olree:989-742-4583 and that comes to the Hillman Clinic. I'm at the 989-742-4583 number most of the time.
Kitty Glomski:All right. Anything else you'd like to add?
Shelly Olree:No, just use us. Call us. That's what we're here for.
Kitty Glomski:Especially if you have questions or concerns or somebody has frightened you over the phone you give Shelly or I a call. And again the 800 is 800-803-7174. And that's for anybody in any county of Michigan. So that'll get you into the nearest MMAP counselor. And if you're in Montmorency County you can call Shelly as well. And you wanna give that number again?
Shelly Olree:Absolutely. 989-742-4583.
Kitty Glomski:Shelly, thank you for joining us and I'm sure that we'll be talking again in the future.
Shelly Olree:You are welcome. Have a great day Kitty. So this is Kitty Glomski 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 US 23 South, Alpena, Michigan 4 9 7 0 7. 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