Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Fall 2020 | Your Story
10 Guard your Medicare number Scammers may use the COVID-19 pandemic as an opportunity to steal your identity and commit Medicare fraud. In some cases, they might tell you they’ll send a coronavirus test, masks, or other items in exchange for your Medicare number or personal information. Don’t fall for it; it’s a scam. It’s important to always guard your Medicare number and check your Medicare Summary Notice (MSN) for errors. Only give your Medicare number to participating Medicare pharmacists, primary and specialty care doctors, or people you trust to work with Medicare on your behalf. Remember, Medicare will never call you to verify your Medicare number. Visit www .Medicare.gov/fraud for more information on protecting yourself from fraud and reporting suspected fraud. Listening and responding We’re committed to providing you high-quality care and service. If you’re not happy with our care and service, we want to know. Some problems call for formal attention. In those cases, you have a right to file a grievance, a complaint, or an appeal. ● Complaint (also referred to as grievance): If you have a complaint about care or services you receive, you can file a grievance. ● Appeal: If we deny a request for service or care and you do not agree, you can file an appeal. If you have a concern, the first thing to do is to contact the Presbyterian Customer Service Center (PCSC). The numbers are listed on your member ID card, in your Evidence of Coverage, and in this newsletter. If the PCSC can’t resolve your concern, you can ask to speak to a Presbyterian Grievance Coordinator. You may also write to the Grievance Coordinator for written details about our procedures or your concerns. Presbyterian Health Plan, Grievance Coordinator, 9521 San Mateo Blvd. NE Preventive healthcare guidelines As a Presbyterian Health Plan (PHP) member, you can benefit from preventive services. Preventive services are activities like routine checkups, screening tests, and shots. These services are important because they can help you prevent a future injury or illness. Find out more about preventive services by looking at the PHP Preventive Healthcare Guidelines at www. phs.org/preventive . You can also talk with your provider about which services are right for you.