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The Importance of the ABN

Why is using an Medicare Advance Beneficiary Notice of Noncoverage (The ABN) so important?

An ABN is important because it allows a provider to administer a service to a Medicare patient that may not be covered by Medicare. As providers you are only able to collect payment from a patient with an ABN once you have communicated to the patient the cost of the service and that it will be there responsibility, since it is not covered under Medicare. ABN’s are a useful tool to have in your belt if you are routinely administering services that medicare does not cover, this allows you to get the income that is rightfully yours and get paid.

How to properly use an ABN

Some practices find this collection tool difficult to use and have trouble implementing it. The ABN can be seen as difficult because it's hard to determine who has ownership of the process.This is because the form needs to be completed and signed by the patient prior to the service being provided. A knowledgeable staff member is needed to explain the rules and pricing to the patient and obtain the signature before the test is administered.

Insurance plans that require the ABN

The ABN can be used for Medicare Advantage Plans also referred to as the commercial insurance plans that offer medicare replacement coverage. Traditionally the ABN is only required for the original Medicare also referred to as the “red,white and blue card”.

The ABN is not to be considered a replacement to a financial policy.

Practices should note that this form is not a way to avoid having a good financial policy in place. Your financial policy should state that patients agree to be responsible for payments for services that their insurance plans do not cover. The ABN should only used for specific individual services or a series of services that a plan does not cover. It's also important to remember that the ABN is not meant to cover any dollars that you are contractually obligated to write off.

Current ABN Version

The latest version of the ABN is the one that has the date 03/2020 in the lower left hand corner. This is the most recent version as of June 2017 and is the correct form that providers should be administering.

If you have questions about ABN’s let us know in our forums section!

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