What is the purpose of an Advanced Beneficiary Notice (ABN) in Medicare billing?

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Multiple Choice

What is the purpose of an Advanced Beneficiary Notice (ABN) in Medicare billing?

Explanation:
The Advanced Beneficiary Notice is the upfront heads-up to a patient that Medicare might not pay for a proposed service and that the patient could be financially responsible for the cost. This notice is given before the service is performed and should clearly describe the service, explain why Medicare may deny coverage, and provide an estimate of what the patient might owe. The patient then can decide to proceed or decline; if they sign and Medicare denies coverage, they may be billed for the noncovered amount up to the estimate listed. If Medicare ends up paying, the patient isn’t charged the noncovered portion. It’s not a request for Medicare payment, not a general consent for treatment, and not a summary of all billable services.

The Advanced Beneficiary Notice is the upfront heads-up to a patient that Medicare might not pay for a proposed service and that the patient could be financially responsible for the cost. This notice is given before the service is performed and should clearly describe the service, explain why Medicare may deny coverage, and provide an estimate of what the patient might owe. The patient then can decide to proceed or decline; if they sign and Medicare denies coverage, they may be billed for the noncovered amount up to the estimate listed. If Medicare ends up paying, the patient isn’t charged the noncovered portion. It’s not a request for Medicare payment, not a general consent for treatment, and not a summary of all billable services.

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