What document do providers who do not accept Medicare assignment miss, which is sent to the patient?

The correct answer is the Medicare Summary Notice. This document is issued by Medicare to beneficiaries to summarize the services received and the amount billed, explaining what is covered, what is not covered, and what patients owe. When providers do not accept Medicare assignment, they can charge beneficiaries directly for the services provided, which affects the way that claims are processed and how information is communicated to patients.

Since these providers are not accepting the predetermined payment rates set by Medicare, the details related to any costs that the patient is responsible for are critical to understand. The Medicare Summary Notice clearly outlines the claims processed by Medicare, any payments made, and what the patient must pay out of pocket. This helps beneficiaries understand their financial responsibilities and cost-sharing amounts.

Other documents, such as the electronic flat file or ledger, typically do not serve the purpose of summarizing Medicare claims for patients, and the encounter form primarily serves as a record for the provider rather than a notification to the patient regarding their insurance claims. Thus, the Medicare Summary Notice is the essential document that ensures patients are informed about their charges when a provider does not accept Medicare assignment.