Medicare enhances readability and fraud protections with streamlined benefit statements
After two years of researching and testing new prototypes, CMS has revamped its Medicare Summary Notices, which are the billing statements beneficiaries receive in the mail every three months. The new forms incorporate larger type and provide explanations of services in plain English, according to CMS.
The simplified language was intended to help improve fraud detection and expedite the appeal process if Medicare denies a claim. The Medicare advocacy director for the Alzheimer's Association, Leslie Fried, told Kaiser Health news that expediting the appeal process is important because many seniors feel they can't afford nursing home care or other costly services. Claim denials can prevent access to care, she explained.
Additionally, Medicare offers a $1,000 reward to beneficiaries who report potential cases of fraud, but until now, the reward has never been spelled out on the form. The newly designed forms will go online this Saturday, but won't be available in paper form until 2013.
Click here to see a side-by-side comparison of the current and new statements.