Wiki Monthly monitoring for ancillary offering of the ABN

[Boloni]

I need to begin monitoring our anicllary department's offering of the ABN to Medicare outpatients. I'm at a loss for an appropriate tool to use. Has anyone developed one they can share, or have any suggestions for the process?
Thanks in advance,
Barb

 

[kevbshields]

I'm not sure how in-depth your audit is . . . are you comparing if the ABN was properly administered to patients, comparing if the proper modifier is present on the claim?

Just assign points to what the important pieces. With the ABNs, if one part is missing or inappropriate the whole ABN is invalid, so "Correctly completed/administered" could be a single point. The modifier on the claim could be another point. This will point you to where education and training are needed.

 

[Boloni]

Thanks, Kevin!
Our problem stems from ancillary staff not offering the ABN when appropriate. We have enough Medicare denials to warrant monitoring this.
Cheers,
Barb

 

[kevbshields]

Sounds like the case. I had that same problem years ago. It took multiple trips, multiple educational efforts and finally a prospective, daily monitoring in order to turn the ship around.

I just lectured my students on the importance (and persistence) required to properly administer these things. I wish you the best of luck.