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Advanced Beneficiary Notice of Noncoverage (ABN)

An Advanced Beneficiary Notice of Noncoverage (ABN) is a form given to the Medicare patient before performing healthcare services that the provider knows are not covered or that the provider thinks may not be covered by the Medicare program.   The form is used to serve as notice to the patient that 1) the service is not covered and 2) that they will be liable to pay for the service. 

When it is Mandatory to Issue an ABN?

When it is Voluntary to Issue an ABN?

Triggering Events (When to give the patient the ABN)

    • Initiations
    • Reductions
    • Terminations
Issuing the ABN

ABN Form and Instructions

  • Header
  • Body
  • Options
  • Additional Information
  • Signature Box

ABN Preparation Requirements

  • Language Choice
  • Effective Versions
  • Number of Copies
  • Reproduction
  • Length and Size of Page
  • Contrast of Paper and Print
  • Font
  • Customization
  • Modification
  • Retention Requirements

ABN Notice and Delivery

  • Proper Notice Requirements
  • Readability Requirements
  • Specificity, Delivery, and Receipt
  • Defective Notice
  • Timeliness
  • Effective Delivery
  • Telephone Notice
  • Capable Recipient
  • Authorized Representatives

Routine Notice Prohibitions and Exceptions

  • Generic ABNs
  • Blanket ABNs
  • Signed Blank ABNs
  • Exceptions
ABN Modifiers

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