Compliance & RegulatoryPregunta 92 de 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

Explicación

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.

Referencia Legal: CMS

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