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Wednesday, March 9, 2011

The ABN Form

Your first impression about an ABN is "What a hassle!" However, an ABN is your friend. Both participating and non-participating providers have signed a contract with the federal government that you know and follow all Medicare guidelines.... including ABNs.

If the patient does not sign the ABN:
For participating providers, when receiving a denial EOB for a payable service, they can not get paid for that denied service from anyone including the patient. For the non-participating provider, who receives a denial EOB, will be instructed by the Medicare carrier to provide a refund to the patient if the patient paid at the time of visit.

ABN: Each patient visit, the doctor must see the patient prior to any services and make an assessment as to if the doctor believes Medicare will pay for all or part of the services that will happen today. If the doctor believes Medicare will reimburse for all services, the patient is not asked to sign the ABN.

However, if after the doctors assessment, after seeing this patient today, that Medicare may deny payment for all or part of the services that will be billed to Medicare, either the doctor or staff member will ask the patient to sign an ABN for today's services, give a copy of the completed signed ABN to the patient, and then provide the services.

The basic purpose of the ABN is to give the patient the choice that if Medicare will not pay for the service, the patient can either, sign the ABN and take financial responsibility, or leave the doctors office having NO services. The ABN, and all other important Chiropractic information, including documenting by Federal standards, are in the Chiropractic Medicare DVD.

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