The ABN

The Advanced Beneficiary Notice of Noncoverage or ABN is used to notify the patient of the fact that Medicare may not cover a service and that they may be financially liable for the service.  More importantly to the doctor, is protects and preserves the right of the doctor to be paid for the service that he performs.

 

The ABN is given to a Medicare patient when the doctor has reason to believe that Medicare will deny a service.  The ABN can also be given to a Medicare patient voluntarily to inform them of their financial responsibility for non-covered services and, as such, can be presented to the patient on the first visit.

 

For detailed instructions on how to complete the ABN and how, when, and why to use it, view the on-demand webinar on the ABN here.

 

Q:  What is the ABN used for?

A:  To inform the Medicare patient of their potential financial liability.

 

Q:  When do I use the ABN?

A:  When you suspect that a service will not be covered or paid by Medicare.

 

Q:  How often do I get an ABN signed?

A:  The ABN is good for one year or until a new incident.  As a rule, when you list a new initial date of treatment on the CMS 1500 form then you need a new ABN.

 

Q:  Who gets the original signed ABN, the doctor or the patient?

A:  Medicare regulations state that the doctor should keep the signed original ABN in the patient’s file.

 

Q:  How long do I keep the ABN in the patient’s file?

A:  Generally you should keep the ABN on file for 5 years after the date of discharge unless state laws require more.

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