Medicare 101: Knowing the Claims Process

After enrolling in Medicare, you’ll receive a Medicare Summary Notice (MSN) by mail every three months.

What will my Medicare Summary Notice show?

Every charge your health care providers or suppliers billed to Medicare during the three-month period should appear on your statement. Your statement will also show what Medicare actually paid your providers and suppliers.

What else should I look for on my MSN?

You should make sure the amounts on your MSN match amounts on your receipts, bills, and other personal records. You should also examine your MSN for any charges you may be responsible for paying a health care provider or supplier.

Can I check items on my MSN before it arrives in the mail?

Yes. You can track your claims by visiting Claims are normally available for tracking or viewing within 24 hours of processing.

Isn’t it difficult to read a Medicare Summary Notice?

Not at all. Below the personal information on your MSN you’ll find an easy-to-read summary of your Medicare claims. This summary includes dates of service, names of providers, deductible and coinsurance information, non-covered charges, and relevant notes. It also indicates any amounts you may be billed.

Your MSN will provide a summary of your Medicare claims during the three-month period your statement covers. You can view a sample MSN for Part A services here and a sample MSN for Part B services here.

If my MSN shows I may be billed for certain services, should I send payment?

Your MSN is a statement, not a bill. Do not send payment to any health care provider or supplier until you are properly billed.

What should I do if I notice a claim has been adjusted?

Contact your provider or supplier. If you owe extra amounts, your provider or supplier may send you a bill. If you’re due a refund, your provider or supplier may send you a check or credit your account.

In summary:

Keep your receipts and bills. Compare the amounts they show to the amounts on your MSN, much as you would do when looking over a credit card statement. If you have insurance other than Medicare, you should also check carefully to make sure your other insurer is meeting all of its primary-payer or secondary-payer obligations.

You can never be too careful when it comes to monitoring your health care claims. The same goes for every aspect of your health care. MedicareMall is eager to assist you in ensuring you’ve got the best health care coverage available at the best price. Contact us now and let us put our two decades-plus of experience and expertise to work for you!

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