Vol. 2, Issue 6, December 1997

Medicare Summary Notice

Medicare benefit notices have taken on a new look! In the past two years, the Health Care Financing Administration (HCFA) and its contractors designed the Medicare Summary Notice (MSN). The easy-to-read MSN replaces the notices that were sent by Medicare Part A for hospital and skilled nursing facility services, and other outpatient services.

Our first MSNs were mailed in October. We have received calls and letters from people who have questions about the change. Here is some information that should help to answer those questions.

• A claim is paid unless there is a message in the "Notes" section that says it was not, or if the "Noncovered Charges" column contains amounts other than zero.
• The "Notes Section" contains valuable information that will help you to understand the way the claim was processed. Please look there for messages!
• The MSN provides the right to appeal the payment or denial decision for a claim. You can circle an item you do not agree with, sign the form and return it to us for review. Some forms are being signed and sent back to us even through full payment was made for the claim (except for deductible and coinsurance). It is not necessary to return the form to us unless a claim was denied or you see a problem with the information that appears.
• The logo in the upper left corner of the form - and this newsletter - refers to the Health Care Financing Administration. HCFA is the government agency responsible for the Medicare program. HCFA also oversees Medicaid; that is why the logo shows both Medicare and Medicaid. It does not mean that you are enrolled in both programs.
• Deductible and coinsurance amounts are not shown separately. The two amounts are added together and shown in the deductible and coinsurance column. The "Notes" section identifies the amount of the deductible.
• The "Dates of Service" do not appear at the top of the claim information. The dates are shown several lines down, below the words "Referred by." They refer to the date the service was rendered, not the date you were referred for the service.

View our Old Medicare Benefit Notice or New Medicare Summary Notice.