Question ABN for Commercial Carriers and Nebraska Medicaid

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Good Morning,

Our ASC is currently working on implementing ABN policy and procedures. I have found all the information in the world on Medicare ABNs but am struggling with commercial carriers and Medicaid. Does each commercial carrier have their own ABN form or do you utilize a general ABN form for these? Also, are you allowed to do an ABN and bill Medicaid patients?

Thank you,

Some commercial carriers have the equivalent of an ABN on their webpages, but you can use anything like that you want to use. You should have your patients signing a financial policy that says they understand that the policy is between them and their insurance carrier, and if they have any concerns about what might be covered, they should contact their insurance company, AND that they are financially responsible if their insurance doesn't pay.

Medicaid - it varies by state. My state says that a patient can see a non-Medicaid provider on a cash-pay basis if they choose to do so, as long as they do not also have Medicare (that would be QMB, and that is not allowed).