What is a Medicare Summary Notice by skatzz

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									                                         It All Adds Up:
                       You + Medicare Summary Notice = Protection Against
                                        Medicare Fraud


What is a Medicare Summary Notice?

The Medicare Summary Notice, also called an MSN, is a quarterly report
of Medicare activity received by beneficiaries. The MSN lists detailed
information about the beneficiary’s original Medicare claims. MSNs are
mailed to beneficiaries enrolled in Medicare Part A and/or Part B.
          The Medicare Summary Notice (MSN) is not a bill.

Use Your MSN To Detect Fraud, Waste and Abuse.

It is important to immediately open and read your MSN to make sure
that you have received all the services listed. Reviewing your MSN is one
of the first lines of defense a beneficiary can use to protect and detect
potential fraud.

Use the Personal Health Care Journal provided by your local SMP to
keep a record of appointment, test, receipts for services and equipment
you have received. You can use the journal to check your Medicare and
health care paperwork to be sure it is correct.

Medicare only mails beneficiaries MSNs every three months. However,
you can view your MSN 24-hours a day by visiting
www.mymedicare.gov. By registering for Medicare’s free, secure service
you can also view all claims received within the past 15 months.
Use Your MSN to Report Fraud, Waste and Abuse.

Review your MSN and compare it to your receipts, records and Personal
Health Care Journal. If you notice any mistakes, or have questions,
report them immediately! Call your provider or plan with your
questions. If you still have unanswered questions call your local SMP.



To locate your local SMP visit www.smpresource.org. OR SMPs can
insert local contact information here.



Here is a snapshot of the Medicare plans available to seniors, what they
cover and information about the statements that you should expect in
order to help you detect and report Medicare fraud.

                  What does it cover?    What information should I
                                         expect?
Medicare Part A   Hospital, Hospice,     Quarterly MSN – Beneficiaries
                  Nursing Care and       will receive a Part A MSN every
                  Home Health            three months that will include the
                                         following information:
                                            o Dates of Service
                                            o Benefit Days Used
                                            o Non-Covered Charges
                                            o Deductible and Coinsurance
                                            o Amounts You May Be Billed
                                            o Additional notes about your
                                               claim
                                         o Deductible Information
                                         o Appeals Information

Medicare Part B   Medical Insurance    Quarterly MSN – Beneficiaries
                                       will receive a Part B MSN every
                                       three months that will include the
                                       following information:
                                          o Dates of Service
                                          o Services Provided
                                          o Amount Charged
                                          o Amount Medicare
                                             Approved
                                          o Amount Medicare Paid
                                             Provider
                                          o Amount You May Be Billed
                                          o Additional notes about your
                                             claim
                                          o Deductible Information
                                          o Appeals Information

Medicare Part C   Medicare benefits        EOB
or Medicare       covered by private
Advantage         insurers
Medicare Part D   Prescription Drugs   Explanation of Benefits (EOB) –
                                       Beneficiaries will receive a Part D
                                       EOB when prescription are
                                       recorded by your pharmacy
                                       benefits manager, every month
                                       you buy prescriptions and/or
                                       when your balance changes.
Reviewing your Medicare Summary Notice is just one of the ways that
you can help detect Medicare fraud.

But remember that protecting yourself from Medicare fraud is the first
line of defense! Here are some steps you can take to protect your
personal information:

  o Treat your Medicare, Medicaid and Social Security numbers like a
    credit card number.
  o Remember that Medicare will not call you or visit you to sell you
    anything!
  o Don’t give out your Medicare number for “free” services.
  o Save you Medicare Summary Notices and Part D Explanation of
    Benefits, but shred them when they are no longer useful. Shredding
    important documents like your MSN, EOB and other bills and
    statement will ensure that thieves cannot get their hands on this
    sensitive information.

Your local SMP is ready to provide you with the information you need to
PROTECT yourself from Medicare errors, fraud and abuse; DETECT
potential errors, fraud and abuse; and REPORT your concerns. Each part
of the equation adds up to keeping you from being a victim of Medicare
fraud, errors and abuse.



Note: This fact sheet is intended for SMP volunteers and beneficiaries who want
more detailed information. A more basic fact sheet for beneficiaries who
want/need less detail is being developed. – 9/08 --

								
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