The new year starts a new quarter, of course, and with it comes new paperwork from Medicare. One that you should pay particular attention to, depending on the type of plan you have is the Medicare Summary Notice, (if you have Original Medicare, including a Medigap plan) or it might be an Explanation of Benefits report (if you have a Medicare Advantage plan). This is the first part of a series on Medicare notices.
These notices are not bills nor invoices. They provide a record, organized by date of service, for the care and treatment you have received.
Why should you review these notices carefully? Well, first, we all know that mistakes can be made. Second, these notices may point up an instance of fraud, waste or abuse of the Medicare system, by using your medical treatment record. Review these notices and feel free to contact me to aid in your review.
Here’s a brief summary from CMS, and The Medicare Rights Center about Medicare Summary Notices:::
A Medicare Summary Notice (MSN) is a summary of health care services you have received during the previous three months. The MSN is not a bill. The contractor that processes your claims for Medicare will send you the MSN, so it may have the name and address of a private company on it, but it will reference Medicare.
MSNs are usually mailed four times a year and contain information about submitted charges, the amount that Medicare paid, and the amount you are responsible for. Note that you may receive an MSN more often if you are being reimbursed for a bill you paid. You can also access your MSN online at www.mymedicare.gov. The e-MSN allows you to look at your MSNs on the web and print copies right from your own computer whenever you would like but it will not replace the paper MSN.
The most important fields on your MSN explain:
* The total amount your doctor or other provider may bill you. The “You May Be Billed” field indicates the total amount that the provider is allowed to bill you. It deducts the amount you already paid. In many instances, Medicare forwards your MSN to your supplemental insurer, which may help with some or all of the remaining costs.
◦ Note: The “Amount Charged” field does not show your costs. You do not need to pay attention to this field.
* Non-covered charges, if any. The “Non-Covered Charges” field shows the portion of charges for services that are denied or excluded (never covered) by Medicare. A $0.00 in this field means that there were no denied or excluded services. If you disagree with a non-covered charge, you should file an appeal.
Try to save your MSNs for about seven years. You might need them in the future to prove that payment was made if a provider’s billing department makes a mistake or if you claimed a medical deduction on your taxes. If you have lost your MSN or you need a duplicate copy, call 800-MEDICARE or go to your account on www.mymedicare.gov.
Do you have family, friends or co-workers that are approaching Medicare age?
If you have a club, association or a location near you that you would like for me to arrange a Medicare/Social Security presentation, please let me know and I will be happy to make arrangements.
Call R Allan Jensen at 303.912.5490.
Posted: Centennial CO 1/20/2015-->