When you sign up for Medicare, you’ll start receiving notices either via snail mail or electronically. These regular notices are called a Medicare Summary Notice (MSN for short). They give you important information about your healthcare and provide a quick way to protect yourself from medicare fraud and scams.
An MSN is similar to the explanation of benefits (EOB) notices you may have gotten when you were on medical insurance through your employer.
You may think it is a bill, but it’s not. Instead, it’s a reference that shows you the medical services and supplies you received during the prior three-month period. It also provides essential financial information.
You’ll want to review it carefully as it helps you understand your care and financial responsibility. It can also help you protect yourself from fraudulent charges, medicare scams, or simple accounting errors on the part of Medicare or a healthcare provider.
This comprehensive guide will aid you in better understanding a Medicare Summary Notice.
What is the Medicare Summary Notice?
A Medicare Summary Notice is a statement that outlines the services and supplies you received and that providers billed Medicare for on a quarterly basis. As such, you’ll receive an MSN once every three months. If you did not receive services or supplies in a quarter, you would not receive one—don’t panic.
You may receive it electronically by opting out of the paper mailer. It’s up to you as the beneficiary how to receive the MSN.
What is on the Medicare Summary Notice?
The Medicare Summary Notice sounds singular, but it’s actually a pair of notices. There are two parts, straightforwardly named “Part A” and “Part B.”
- Part A: This section covers claims or requests for payments from a provider for hospital, skilled nursing in-patient, and specific home healthcare and end-of-life hospice services. It will show you the dates of the claim, whether or not Medicare approved the claim, the amount you could be billed from the service/facility, and where you stand on meeting the deductible. From there, the MSN will give you tips on reading it and detailed information about claims, such as how many days the benefit was used.
- Part B: The second section goes over outpatient costs, such as diagnostic tests, doctors’ services, and ambulance rides. Like Part A, it also includes tips for reading the notice and more detailed information on claims.
The MSN will also include information on appealing claims on the fourth page.
Look at it closely, ensuring that the facilities, dates, and claims are all correct.
Why Do Beneficiaries Get a Medicare Summary Notice?
MSNs are not junk mail. They help beneficiaries track healthcare expenses. You can ensure they’re in your spreadsheet, WayWiser, or however you track expenses and budget and that they were taken care of, helping you cut down on stress or missed payments.
However, MSNs don’t simply hold you accountable. They also hold the healthcare system—and potential bad actors—accountable.
MSNs help you double-check claims to ensure Medicare has only been billed for services and supplies you received. It can help you flag clerical errors as well as fraudulent charges. By carefully double-checking dates, claims, and facilities, you can detect these errors or fraud and protect yourself from overpaying for healthcare.
If you’re caring for somebody on Medicare, it’s important to review their Medicare Summary Notice yourself as you may be more likely to realize when something is off.
What to Look Out For on the Medicare Summary Notice
Again, you’ll want to review your MSN carefully. These tips will ensure you leave no stone unturned as you look at yours.
- Sound familiar? Check the notice to ensure all of the facilities, providers, and services are ones you know and have actually used.
- Check dates. You may have used a provider in the past but not during the three-month period applicable to this MSN. You may have used a benefit for two days, but the report may save five. Make sure the dates are accurate.
- Compare. Keep receipts and statements from providers. Cross-check them with your MSN to make sure they match up.
- Pick up the phone. If something doesn’t match or add up, pick up the phone and ask Medicare why. You may need to call your provider and ask them to resubmit the claim so it’s billed correctly. You can reach them at 1-800-MEDICARE (1-800-633-4227)
Keep these notices on file until the claims have been paid. It helps you have a paper trail if something is amiss.
How Adult Children Can Help Review the Medicare Summary Notice
It never hurts to have an extra set of eyes on something, particularly if a Medicare beneficiary is experiencing cognitive or vision issues. Having someone else, such as an adult child, review the MSN can help a beneficiary flag scams and fraudulent charges, as well as any errors made by Medicare or a provider when billing.
Adult children can follow the same process as their parents when reviewing an MSN. Some helpful tips include:
- Review quickly. Review the MSN as soon as your loved one gets it. The quicker an issue is flagged, the quicker it can get resolved.
- Look at it with a fine-tooth comb. Cross-check with statements and other records to ensure dates, services, supplies, and facilities are all completely accurate. Flag discrepancies and call Medicare or the facility with concerns.
- Keep good records. Tip two is easier if you have organized records of tests, hospital stays, and doctors’ appointments. Have a folder of paper statements and receipts.
A Medicare Summary Statement (MSN) is not a bill, but it provides essential information about the services and supplies you receive during a three-month period. Reviewing it carefully — and having someone else, such as an adult child — do the same can help you protect yourself against fraudulent charges, missed payments, or overpaying for services and supplies because of a healthcare provider or Medicare errors. Keep records, such as receipts, so that you can double-check dates and charges. Flag anything that seems amiss. It’s better to be safe than sorry.
How To Keep Track of Medicare Expenses More Easily
There can be a lot to look back at when you’re only getting a Medicare Summary Notice once every quarter. Most of us can barely remember what we did last week. Trying to recall our mom or dad’s doctor visits 3 months ago is a lost cause.
Using a tool like WayWiser can be a huge help. If you have doctor visits tracked on the shared calendar, it’s easy to take a quick look back when you need to line things up. You can use the activity feed to double check with the rest of your Trusted Circle to verify anything that seems out of place and all said and done, you can upload a pdf of each MSN into the Family Vault so that you can easily find them later if you need to double check on anything.