Wiki ABN for Medicare

[susansisson]

I have a questions about ABN and Medicare.

Our practice currently has no contract/credentialing with Medicare would we still be able to use a ABN form since we cant bill Medicare at all or would we have to turn those patients away all together?

Thank you

 

[thomas7331]

No, unless you're a DME provider, if you're not enrolled, you can't use the form. The ABN regulations are covered in Chapter 30 of the Medicare Claims Processing Manual. Section 50.3 states: "With the exception of DME POS suppliers (see Section 50.10), providers and suppliers who are not enrolled in Medicare cannot issue the ABN to beneficiaries."

If you're going to provide or order/refer services to Medicare beneficiaries, you'll need to enroll and submit claims when required or else go through the process of opting out of the Medicare program.