Compliance & RegulatoryQuestion 92 of 100
An Advance Beneficiary Notice of Noncoverage (ABN) is given to a Medicare patient to:
a.Guarantee that Medicare will pay
b.Collect the copay in advance for all visits
c.Serve as the patient's insurance card
d.Inform the patient in advance that Medicare may not pay for a service so the patient can decide whether to accept financial responsibility
Explanation
An ABN notifies a Medicare beneficiary before a service is provided that Medicare is likely to deny payment, allowing the patient to choose whether to receive the service and accept liability. Without a properly executed ABN, the provider generally cannot bill the patient for the denied amount. It must be given in advance and clearly explain the reason coverage may be denied.
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