A Medicare Advantage, Medicare drug, or other Medicare health plan sends an Explanation of Benefits and controls its own claim and appeal channel. Contact that plan for current claim details.
Choose an official way to see the claim
Sign in to your secure Medicare account to see Original Medicare claims after they are processed. Medicare says a processed claim is usually visible there within 24 hours. You can also review the paper or electronic MSN. A paper MSN is sent every six months when services or supplies were billed during that period; electronic MSNs are available for months with processed claims.
Match the notice to your records
- Confirm the provider or supplier, service date, and item or service.
- Check whether Medicare approved the claim and how much Medicare paid.
- Compare the maximum amount you may owe with the provider bill, receipts, Medigap information, and other insurance records.
- Keep the notice, bill, receipt, and any explanation from the provider together.
The maximum shown on an MSN is not automatically a demand for payment. The provider bill and payments from other insurance can affect what remains due.
Resolve missing or incorrect information
If a recent service is not listed, first confirm that Medicare has processed the claim. Ask the provider or supplier whether it submitted the claim and whether the information was correct. If a listed service, date, or amount looks wrong, contact the provider and use the Medicare contact instructions on the notice or official account.
Handle a denied item or service
Ask the provider whether it sent the correct information and whether it can correct and resubmit the claim. If you disagree with Medicare's coverage or payment decision, follow the appeal instructions and filing date printed on the last page of your MSN. Medicare identifies this first Original Medicare appeal as a redetermination. Do not rely on a general deadline summary when your notice gives the controlling date and submission details.
Protect the Medicare number
The MSN and online claim record contain personal health and Medicare information. Use only Medicare.gov, avoid sending the full notice through unsecured messages, and share it only with people or organizations that need it.
Official sources
- Medicare — Check a claim's status
- Medicare — Medicare Summary Notice
- Medicare — Secure account and electronic notices
- Medicare — Original Medicare appeals