With the new Advanced Beneficiary Notice (ABN) coming into effect on June 21, 2017, it is a wonderful time to give a refresher on the proper way to fill out the form. ABNs are provided to educate the patient on an item/service that may not be covered by Medicare but may aid in the patient’s treatment. The ABN, when filled out properly, lets the patient know what the item / service is, when and by whom the item/service will be given /performed and the potential cost of the service. With all of the information provided, the patient can decide whether or not to have the item/service and sill sign the notice. It is important to remember without a properly filled out written notice, the patient is not financially liable if Medicare denies the item/service.
All the blanks / boxes on the form should be filled out completely. Remember to use the full names of the Notifier (supplier/treating physician) and patient. The complete item/service that will be given/performed should be entered into box “D”. For example: if the patient is going to be given physical therapy (PT) rather than writing just “physical therapy” the actual PT modalities should be noted. In Box “E” state why the service may not be paid. The estimated cost is necessary for the patient to know how much the treatment may cost if it is not covered by Medicare. Per Medicare, the estimate should be reasonable for all items/services noted. The cost should be within $100 or 25% of the fee for the item/ service. Always makes sure the patient marks the option they are choosing and the notice is signed in cursive and dated (including month, day and year).