Educate Medicare Patients Using MSN
Medicare patients can get MSNs electronically. If they choose eMSNs, they’ll get a monthly email with a link to claims information. With MSN, they won’t have to wait 3 months for a paper copy in the mail.
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2. The Medicare Summary Notice (MSN) is a summary of
health care services and items patients have received
during the previous three months. MSN is not a bill. This
document is intended to help patients remember the
physicians, specialties, supplies, and services involved in
their care. The contractor that processes claims for
Medicare will send the MSN, so it may have the name and
address of a private company on it. For patients enrolled
in original Medicare, an MSN is mailed out every three
months (if any claims were submitted to Medicare during
that period). Medicare also makes this notice available
online at Medicare.gov.
3. The MSN is similar to the explanation of benefits (EOB)
statement, which itemizes everything billed to Medicare,
including what services were charged, what Medicare paid
for, and what the patient still may owe their providers.
There are separate notices for Part A, Part B, and DME, but
each notice provides the same type of information. This
document is intended to help patients remember the
physicians, specialties, supplies, and services involved in
their care. Understanding the information contained in an
MSN can minimize the frustration often felt by both
patients and providers trying to grasp benefit coverage. In
many instances, Medicare forwards your MSN to your
secondary insurer, which may help with some or all of the
remaining costs.
4. Medicare patients can get MSNs electronically. If they choose
eMSNs, they’ll get a monthly email with a link to claims
information. With MSN, they won’t have to wait 3 months
for a paper copy in the mail. In addition to the health care
services you received in a given quarter, your MSN lists:
• The amount providers billed Medicare for those services (Note:
The “Amount Charged” field does not show your costs.)
• The amount Medicare paid providers for each service
• The amount you may need to pay directly to providers
(indicated in the “You May Be Billed” field). Note that you will
receive a bill from providers and do not need to pay anything
until you have received a bill.
• Any non-covered charges. This field shows the portion of
charges for services that are denied or excluded (never
covered) by Medicare. $0.00 in this field means that there were
no denied or excluded services. A charge in this field means you
are responsible for paying it. If you disagree with a non-covered
charge, you should file an appeal.
5. Medicare encourages beneficiaries to compare claim details
on their MSNs with the bills they receive from their
providers, including verifying provider name, date of
service, billing code(s), and descriptions. Patients often call
questioning a service that shows up on their MSN when they
do not recognize it or remember receiving it. While the
charges are usually accurate and fair, patients do not
always have a clear understanding of the services they
received and the coverage parameters for those services.
Although these calls can be daunting and quite tedious in a
busy office, consider the call an opportunity to educate the
patient and, sometimes, the physician, too.
6. MSN and Medicare Patients
• If Medicare patients have other insurance, they can
check if it covers anything that Medicare didn’t.
• They can keep receipts and bills, and compare them to
MSN, and can be sure of getting all the services,
supplies, or equipment listed.
• They can compare you with the bill to make sure you
paid the right amount for your services if they paid a
bill before receiving MSN.
• If an item or service is denied, they can call your
office to make sure that the correct information is
submitted. If they disagree with any decision made,
they can file an appeal. The last page of the MSN gives
you step-by-step directions on when and how to file an
appeal.
7. For providers, MSN is an opportunity to educate patients.
Patients will call about a procedure they don’t recall
receiving. Chances are they are not aware of the formal
medical terminology of the procedure they received. For
example, perhaps the patient sees on the MSN CPT®
20610 Arthrocentesis, aspiration, and/or injection, major
joint or bursa (e.g., shoulder, hip, knee, subacromial
bursa); without ultrasound guidance and does not believe
they had such a complicated-sounding procedure
performed during their visit. A quick explanation that this
is the cortisone shot they received will ease their concern
about any fraud or abuse, and now they know the name of
the procedure for cortisone injections.