Call me crazy, but I cannot find any factual information on rules for using ABN's for commercial insurance. My main question is, if the denial is for contractual (CO) then can we still bill the patient if there is an ABN signed? I know that you cannot with Medicare, but not sure about non Medicare. All the Premera individual plans in Washington State are denying fundus photos (92250) without a pre auth, which is insane. Even if we get a referral from PCP, they still deny.