The Medicare Summary Notice Is Not a Bill: Match It to the Stay Line by Line

After a hospital stay, two papers can show up that look like bills. One may be the bill from the hospital or a doctor's office. The other is a notice that describes what the insurance program processed. If your parent has original Medicare, that second paper is usually called the Medicare Summary Notice, or MSN. If your parent has a Medicare Advantage plan, the plan sends its own statement, usually called an Explanation of Benefits. Both are useful. Neither one is a bill.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Find out which paper you have

Read the top of the notice. It names the program or plan and says what the document is. If it says it is not a bill, take that at its word. Medicare's own explanation of the MSN, on medicare.gov, walks through each section if the wording is unfamiliar.

Check the stay, not the total

Start with the service dates. Do they match the days your parent was in the hospital, plus any follow-up visit? Next, check the provider name. Is it the hospital, the doctor, or a supplier you did not expect? Then go down the list of services. Find the lines you remember: the room, the tests, the therapy sessions, the prescriptions. A line you do not recognize is a question, not proof of an error.

Compare the notice to the bill

When the hospital bill comes, put it next to the notice. The two should describe the same stay. Look for services that appear on the bill but not on the notice, and for amounts that do not match what the notice says was processed. Ask the billing office to explain each mismatch in writing. Keep the notice and the bill together in the same folder.

Questions to ask the billing office

Ask which claim number this line belongs to. Ask whether the service was processed under the stay or under a separate claim. Ask what part of the amount is the program's share and what part is listed as your responsibility. Ask who to call if the dates are wrong. Write down who you spoke with and what they said. Do not pay a line you cannot yet match to the stay.

If the notice does not match what you remember

Do not argue from memory alone. Pull the discharge papers and any list of what your parent was given during the stay. The hospital's patient billing contact, the insurance program's phone line, and the state health insurance counseling program for seniors are three places to check. Ask for a corrected statement if a line is wrong. The Sources page lists where the rules in this piece come from.