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Medicare Summary Notices And Explanation Of Benefits

A Medicare Summary Notice (MSN) is not a bill. It is a notice mailed quarterly to Medicare Beneficiaries which includes a list of services provided during the past 3 months. It will also list any services that were denied or not covered by Medicare.

An Explanation of Benefits (EOB), is a monthly statement and includes a list of services provided, how much the provider billed, how much the plan pays and how much you may owe.

In reading your MSN’s and EOB’s, make sure you look for:

Provider Location

Date of Service

Duplicate Billing

If the insurance company rejected a claim, look for a note or reason code explaining why it was denied.

Make sure you have not been charged for a service you did not receive or billed multiple times for a service you received once.

It is important to keep a file of your MSN’s and EOB’s. These are important documents, not only to verify the services you did receive, but to dispute a charge or to contest an insurance decision. Reading your MSN’s and EOB’s can help you combat Medical Identity Theft and ensure accurate medical records.

If you suspect billing fraud, contact NY StateWide Senior Action Council, and the Medicare Fraud Hotline at 1-800-333-4374, all calls are confidential and free of charge.

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