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ABN training for hospital staff

Staff Development Weekly: Insight on Evidence-Based Practice in Education, July 9, 2004

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Question: Maura works in the admitting department of a hospital. She is responsible for greeting and registering all patients. Andrew, the admitting manager, asks Maura to have all patients sign an ABN when they register. "Medicare has been denying payment for many of our services. We can only bill Medicare patients if they sign an ABN, but the referring physicians never ask patients to sign one, and it takes too long to determine whether Medicare will pay for a service."

Andrew says he wants every patient to sign an ABN so the billing department can charge the patient for any services that Medicare denies. Maura thinks this is a good idea, so she agrees to it.

What would you do?

Answer: Providers cannot obtain routine ABNs from Medicare beneficiaries. Providers must tell beneficiaries the specific services that may be denied and give the reason for the potential denial. Note: For exclusions to the prohibition on routine ABNs, see the section "Prohibited ABN use."

Editor's note: The above case scenario is from the new online course, "ABN training for hospital staff." For more information on this and other courses in our Compliance library, go to www.hcprofessor.com and click on Compliance.

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