Corporate Compliance

Note: CMS provides guidance on voluntary use of ABNs

Medicare Insider, December 1, 2009

Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!

Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

In a recent transmittal (R1840CP), CMS provides guidance on the voluntary use of ABNs.  ABNs are prescribed forms of liability notification that are provided to beneficiaries prior to the delivery of outpatient services in circumstances where the provider believes that Medicare will deny coverage, resulting in beneficiary liability for those services. Prior notice is generally mandatory when the provider expects Medicare to deny coverage for any of the following reasons:

  • The services do not meet Medicare’s medical necessity guidelines for those services;
  • The services are screening services that are being provided more frequently than Medicare provides a benefit for; or
  • The services are custodial in nature.

Click over to the MedicareMentor Blog to read more.

Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!

    Billing Alert for Long-Term Care
  • Billing Alert for Long-Term Care

    It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...

  • Strategies for Health Care Compliance

    News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...

  • Medicare Insider

    Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...

  • Core Skills for Hospital Case Managers:

    A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...

  • Homecare Audit Prevention:

    Home health care is under more layers of regulatory scrutiny than ever before. Plus, under health care reform, the...

Most Popular