Rebecca Corkern
HIM 2165
ABN Education Script
An important aspect of advance beneficiary notice of non-coverage (ABN) is for
healthcare providers to understand when to use it and how to provide it to patients. ABN forms
help inform patients they may have to pay for a medical service out of pocket, as Medicare might
not cover it. The provider must give the form to the patient before the service. Therefore, it is
their responsibility to ensure patients understand why they are signing the form and what their
options are if Medicare refuses to pay for the procedure. If the healthcare provider does not give
the ABN to the patient, and Medicare denies the claim, the provider has no legal right to bill the
patient.
Patients can receive an ABN form from their healthcare provider in many settings,
including hospitals, clinics, and physician's offices. ABN use and guidance are crucial for
providers to communicate reimbursement policies and procedures with their patients and staff.
With the help of the ABN form, patients can decide whether to receive and pay for the service,
refuse or receive the service, or submit a claim for Medicare coverage. Educating patients on
their options with the ABN form is essential for patient-centered care and, more importantly,
helps providers avoid legal or compliance issues. By providing correct and complete information
about the ABN form, providers guarantee that their patients will understand their responsibilities
and the financial obligations involved with their healthcare decisions.
With ABN, patients have the option of paying for the service, refusing it, or submitting a
claim to Medicare for coverage. If patients choose to submit a claim, they must complete the
form correctly only to receive a notice of non-coverage. They can then contact their insurance
company, Medicare, or state assistance program. New Medicare enrollees must understand the
ABN process and their options to avoid unexpected medical bills.
