by Jared Staheli
June 18th, 2015
Effective July 1, 2002, the MSN is used by all carriers and intermediaries.
The MSN is the primary vehicle by which beneficiaries are notified of decisions on their claims for Medicare benefits. The intermediary or carrier mails a single MSN at the end of the month to each beneficiary for whom claim was processed during the month to inform the beneficiary of the disposition of all claims. Contractors shall issue No-Pay MSNs on a quarterly/90 day mailing cycle. MSNs with checks to the beneficiary will continue to be mailed out as processed. To ensure that all messages are uniform throughout the Medicare program, intermediaries and carriers may not use locally developed MSN messages until approved by the regional office (RO).
The MSNs are not sent to providers. Providers receive remittance advice records. (See Chapter 22 for instructions about the provider remittance record.)
The MSN contains the following sections or areas:
• Claims Information;
• Message; and
Detailed requirements for completion of each section are included in §10.3. Generally, carrier and intermediary requirements are the same. Where there are differences or where the specific specification applies to only the carrier or to only the intermediary, the difference is noted in the specific instruction.
Although every attempt has been made to make the MSN as simple as possible, the MSN is sufficiently complex that contractors must maintain continuing training efforts directed at beneficiaries and providers for understanding and interpretation of data on the MSN. Although providers are not mailed copies of MSNs, beneficiaries frequently show MSNs to providers to establish deductible status for provider billing.