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Learning How to Read the Medicare Summary Notice

The Medicare Summary Notice or MSN is a statement issued by Medicare on a quarterly basis to all of their recipients. This notice outlines for you every claim that has been filed within the past 3 month period. It also details which portion of each claim was covered by Medicare, and what the recipients' financial responsibility is. These notices can sometimes be difficult to understand if you don't know how to read them.

How to Read the First Section

The top area of the first page of every Medicare Summary Notice is typically the same every time. In the upper right corner you will find the date the notice was generated and mailed to you. Under that is Medicare contact information for if you should have any questions or concerns. Below that is your Medicare member number, which you will need to have when you contact them with your issue (in addition to this you will need the date of the Notice, as well as the date that you were provided the service in question).

In the upper left corner of your Medicare Service Summary you will find your mailing address. If this information is wrong or needs updating you will want to contact the Social Security Administration to update their records, and call the number in the section to the right to let Medicare know. It is important that you complete your updates with both agencies to avoid missing any important information that either might send to you.

Under your address there is always a helpful hint regarding protecting yourself from Medicare fraud. After this information and before your claims summary information section begins is a date range. This range tells you the time frame in which the claims on that particular Medicare Summary Notice were filed.

After the information outlined above comes the section of your MSN known as "Part A". Part A of the MSN details inpatient hospital claims. This section will include any claims involving or related to visits to the hospital in which you were admitted for a stay of at least one overnight. Information that will be included in this section include the dates that you were provided the service, the amount of days stayed and any charges that were assessed that Medicare will not cover. Additionally, this section will inform you about what portion of this coverage was applied to your coinsurance and or deductible, as well as the dollar amount your provider may request from you. The name and address of the facility will also be included for any questions you may have. After this information there is another section with special notes regarding coverage (if applicable), a detail of your deductible status, information regarding how to appeal, and any other general information Medicare thinks might pertain.

Understanding "Part B"

The second section of the MSN is known as "Part B". This section details claims involving outpatient care. This section basically includes any claims that do not involve a hospital stay. This can be anything from a pharmacy claim to a physician claim.

The top portion of Part B is the same as Part A. It includes Medicare contact information, the report date, your address, and the reports date range. Also in the upper portion are hints on how to avoid becoming a victim of fraud.

Much like Part A, the same basic information can be found in the benefit summary section of Part B. It should be fairly self-explanatory but you can always call Medicare if you require assistance in learning how to read the Medicare Summary Notice.

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