Corporate Compliance

Tip: Increase awareness of areas where ABN use is prohibited

Compliance Monitor, September 15, 2004

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Providers cannot obtain routine Advance Beneficiary Notices (ABNs) from Medicare beneficiaries. Routine ABNs include the following:

1. Generic or blanket ABNs-routine provisions of ABNs stating that denial by Medicare may be possible, but give no reason

2. Signed blank ABNs-a signature is obtained from a patient without explaining which services may be denied. An ABN must be completed in its entirety prior to being presented to the patient for signature.

Exceptions to routine ABN prohibition include cases in which

  • services are always denied for medical necessity
  • items are services are experimental
  • Medicare will cover items and services only a limited number of times over a given period
  • Medical equipment and supplies are denied because the supplier had no supplier number or made an unsolicited telephone call.

    This tip was excerpted from the ABN Training Handbook for Hospital Staff and Physicians. Copyright 2004 by HCPro Inc. For more information, click here.



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