ABN Gets a Makeover

Imagine being liable for non-covered health care services provided to a Medicare patient. It can happen to you. To safeguard against it, providers, practioners, suppliers, and laboratories should have Medicare beneficiaries sign an Advance Beneficiary Notice (ABN). It won’t be long, however, before the Centers for Medicare & Medicaid Services (CMS) no longer accepts the ABN forms you’re currently using.

The newly revised form (CMS-R-131) is a combination of forms CMS-R-131-G and CMS-R-131-L, and the gold standard come March 1, 2009. The revised ABN replaces ABN-G, ABN-L as well as the Notice of Exclusion From Medicare Benefits (NEMB).

As you are probably well aware, ABNs are used to inform patients enrolled in the Medicare Fee-For-Service (FFS) program of their potential liability for non-covered services. ABNs are not required for care excluded from coverage or that fails to meet a technical benefit requirement. What you may not know is, regardless of who gives the notice, the billing entity is held responsible for its delivery.

For the latest guidance regarding the revised ABN form, please read CMS Transmittal 1587, Change Request 6136, released September 5.


Latest posts by admin aapc (see all)

Leave a Reply

Your email address will not be published. Required fields are marked *