American College of Physicians: Internal Medicine — Doctors for Adults ®

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Medicare testing new form to better explain patient benefits

From the January 1997 ACP Observer, copyright 1997 by the American College of Physicians.

HCFA is testing a new form that it hopes will more clearly explain benefits to Medicare beneficiaries.

The new Medicare Summary Notice (MSN), which is already being used in parts of Texas, will eventually replace the Explanation of Part B Medicare Benefits (EOMB), the Part A EOMB and the Part A Medicare Benefits Notice. HCFA says that the new form, which it has been developing for more than two years, will provide beneficiaries with easier to understand claims and deductible information than previous forms.

The MSN form will include the following features:

  • A toll-free telephone number on each form will direct beneficiaries with questions to their local Medicare contractor. HCFA will track patient questions and problems reported to these numbers.
  • A "Help Stop Fraud" message on the new forms will alert patients to Medicare fraud scams. Because anti-fraud messages will be printed on the forms by local Medicare contractors, they will reflect local scams affecting patients in the area.
  • The names of referring physicians—not just the names of the labs and other service providers—will be listed on the new form. According to HCFA, patients often don't recognize the name of labs or other facilities where they have received services.
  • The form will provide up-to-date information on the patient's deductible, as well as a special notes section explaining how many days remain in a benefit period and how much of the deductible the patient has paid.
  • The notice will be available in English and Spanish.

HCFA began testing the MSN at Texas Blue Cross in October; this month, nearly half of all states will begin using the new form. The form is expected to be in full use by late 1997.

HCFA emphasizes that the form's new look does not signal any change in Medicare benefits, and that the form is simply a notice and not a bill. The agency also notes that because not all Medicare contractors are testing the form, beneficiaries may continue to receive older notices and the MSN form simultaneously. For example, a patient could receive a MSN form for durable medical equipment and an EOMB for a doctor's visit.

For a brochure on how to read the new MSN form, call your local Medicare contractor.

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