Why did I receive a Medicare Summary Notice, and what should I do with it?
Answered by 19 licensed agents
A Medicare Summary Notice (MSN) is a quarterly statement sent to individuals with Original Medicare (Parts A and B) that summarizes their claims for services and supplies billed to Medicare during that period. It details what Medicare paid, what you owe, and if the service was approved. MSNs are not bills; they are a record of claims and payments. There is nothing you need to do with the statement.
A Medicare Summary Notice (MSN) is sent after a healthcare provider files a claim with Medicare for services. The MSN summarizes the claim details, including what was billed and paid to the provider. The Medicare-approved amount is how much Medicare paid on the charges, and what’s left over is your obligation if you don’t have another secondary insurance to pick up those charges. You should always review your MSN to ensure the information is accurate and to track your out-of-pocket expenses.
You receive a summary whenever Medicare is billed on your behalf. It is for your reconciliation. It makes sure you know what has been billed and how, with exact numbers. It helps prevent fraud, waste and abuse and insures you are aware and can verify services received and the billing is correct. I always look at my summaries when they come. You may find something was coded wrong and perhaps you were overcharged? It is a particularly effective way to keep you up to date on your health care and billing history. If everything looks right, you need not do anything, but my advice is to keep the summaries somewhere for your records.
It is not a bill. It is a summary of what was paid by Medicare and also your portion. Part of the reason is to check and see if there are any discrepancies and your are not being charged for a service you didn’t receive.
Your Medicare Summary Notice usually is automatically generated and mailed to you quarterly. This notice is not a bill. It will show you all of the Medicare claims for the last quarter and weather the services are Medicare approved or not. This notice could also show other services that are fraudulent. Over the past few years, we have been seeing more and more services submitted under a Medicare beneficiaries number and it's really not from them, it's fraudulent.
Most people I work with will review and keep their Medicare Summary Notices on file.
Since fraud, waste and abuse is top of mind nowadays, a MSN informs you that charges have been processed and await Medicare's approval as a legitimate test or screening. With rampant identity theft, if something seems awry, report it asap so you can stop the fraud/abuse in its tracks! You can file it away with the yearly tax returns in case you are ever audited by the IRS.
Check it over to make the charges are for services you received. The notice will also show if you owe anything. Such as your part B deductible no being met yet.
You had medical appointments or services performed. This summary indicates what Medicare paid, if you have a secondary insurance plan (such as a Medigap plan), and if you have met your current year deductible.
A Medicare Summary Notice (MSN) is a statement you receive every 3 months if you have Original Medicare. It’s not a bill—it shows the medical services you received, what Medicare paid, and what you may owe. Review it carefully to make sure the information is correct, compare it with your doctor’s bills, and keep it for your records. If you notice any mistakes or charges for services you didn’t receive, report them to Medicare at 1-800-MEDICARE.
All your services or supplies that providers and suppliers billed to Medicare during that period
What Medicare paid
The maximum amount you may owe the provider
What should you do if you get this notice?
If you have other insurance, check to see if it covers anything that Medicare didn’t.
Keep your receipts and bills, and compare them to your MSN to be sure you got all the services, supplies, or equipment listed.
If you paid a bill before you got your notice, compare your MSN with the bill to make sure you paid the right amount for your services.
If an item or service is denied, call your doctor’s or other health care provider's office to make sure they submitted the correct information. If not, the office may resubmit. If you disagree with any decision made, you can file an appeal. The last page of the MSN gives you step-by-step directions on when and how to file an appeal.
You receive a Medicare Summary Notice (MSN) if you have original Medicare (Parts A and B) and have received services covered by Medicare during the past three months. The MSN is not a bill, but rather a statement summarizing the services, supplies, and equipment you received, how much Medicare paid, and how much you might owe. It's crucial to review your MSN to ensure accuracy and to catch any potential errors or fraud.
Why You Received the MSN:
Original Medicare Coverage: You have original Medicare (Parts A and B) and used covered services.
Services within the Past Three Months: You received medical services, supplies, or equipment that Medicare covers.
No MSN for Medicare Advantage: If you have a Medicare Advantage plan, you won't receive an MSN; instead, you'll get an Explanation of Benefits (EOB).
What to Do with the MSN:
Review Carefully: Open and read your MSN as soon as possible.
Verify Charges: Check the MSN against your records of medical bills and payments to ensure accuracy.
Contact Provider if Needed: If there's a discrepancy or denial, contact your healthcare provider to clarify the issue.
Appeal Denials: If Medicare denies a claim, you have the right to appeal the decision. The MSN provides instructions on how to file an appeal.
Track Expenses: Use the MSN to keep track of your Medicare-related expenses.
Prevent Fraud: Reviewing MSNs can help you detect errors or potential fraud.
Digital MSNs: You can also access and manage your MSNs online at MyMedicare.gov medicareenrollment.com.
If you're referring to a claim as a summary notice that tells you what the doctor or hospital builds, what Medicare paid and what you owe. If anything, if you are just on original Medicare that would mean you would owe the 20% that Medicare didn't cover
It would be different if you're on a Medicare supplement plan or Medicare advantage plan according to the plan coverage and I'm referring to the advantage plan. Supplement plan would be covered at 100% after the annual part b deductible if that applied
Medicare Summary Notice is a document is for people with Original Medicare receive to review their healthcare claims. It summarizes the services billed to Medicare, what Medicare paid, and what the beneficiary may owe. They are typically mailed every 4 months, but you can also access them online.
This is essentially your EOB for Medicare. It's a summary of your Medicare claims within a three-month period for what Medicare paid for and what you may owe to a provider or facility. You should look it over and make sure it's correct before doing anything. The MSN is not a bill and won't ask you to pay Medicare anything, however, is a good reference to track out of pocket expenses that may have been charged by providers.