|
Quarterly Medicare Summary Notice (MSN)
Printing Cycle
Reference: Trans. 955, CR #5062, Pub. 100-04, Medlearn
Matters Number: MM5062
Published Online: 6/5/2006
Printer
Friendly Page
Note: This article was revised on May 24, 2006, to correct the
implementation date for DMERCs. That date should have been July 3, 2006. The
transmittal number also changed, since Transmittal R945 (dated May 12, 2006)
was rescinded and replaced with Transmittal R955 (dated May 19, 2006). All
other information remains the same.
Provider Types Affected
Physicians, providers, and suppliers submitting claims to Medicare
carriers, durable medical equipment regional carriers (DMERCs), fiscal
intermediaries (FIs), and/or regional home health intermediaries (RHHIs) for
services provided to Medicare beneficiaries
Impact on Providers
This article is based on Change Request (CR) 5062, which instructs
Medicare contractors (carriers, DMERCs, FIs, and RHHIs) to print and mail No-Pay
Medicare Summary Notices (MSNs) on a quarterly schedule (rather than the current
monthly schedule).
Background
Current Centers for Medicare & Medicaid Services (CMS) instructions
require all Medicare contractors to issue a MSN to each beneficiary for whom a
claim was processed during the last 30 days (possibly for services received more
than 30 days ago) to inform the beneficiary of the disposition of all claims
(i.e., a record of services received, the status of any deductibles, and appeal
rights).
In an effort to reduce overall operating costs, CR5062 instructs your
intermediary/carrier to change from their current monthly (30 day) No-Pay MSN
mailing schedule to a quarterly (90 day) No- Pay MSN mailing schedule. All MSN
information should continue to print; however, summations will occur on a
quarterly basis as opposed to a monthly basis.
No-Pay MSNs are the standard, system-generated MSNs produced for
beneficiaries in which Medicare did not issue payment to the beneficiary for the
respective claim. Beneficiaries often need these MSNs in order to obtain payment
from another payer/insurer.
In those situations where a No-Pay MSN is needed or lost by a beneficiary,
they can request a No-Pay MSN by calling 1-800 Medicare. On-demand requests will
be generated and mailed once the request is made.
In summary, CR5062 provides the following instructions:
-
Beginning no later than October 1, 2006, Medicare contractors will issue
No-Pay MSNs on a quarterly/90-day mailing cycle as opposed to the previous
monthly/30-day mailing cycle;
-
MSNs with checks will continue to be mailed out as processed; and
-
If a beneficiary requests a monthly No-Pay MSN (as opposed to the
quarterly MSN), then Medicare contractors must generate and mail out the MSN
at the time of the request.
Implementation
The implementation date for the instruction is June 12, 2006, for
carriers, July 3, 2006, for DMERCs, and September 1, 2006 for FIs.
Additional Information
For complete details, please see the official instruction issued to your
carrier/intermediary regarding this change. That instruction may be viewed on
the CMS web site at:
http://www.cms.hhs.gov/Transmittals/downloads/R955CP.pdf
If you have any questions, please contact your carrier/intermediary at their
toll-free number, which may be found on the CMS web site at:
http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.pdf
|
