Health Information Management

Pay-per-view: Unscramble the complexities of ABNs

APCs Insider, December 30, 2011

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Just because a physician considers a service or procedure medically necessary doesn't mean insurance carriers will pay for it. When a service or procedure is not covered, facilities must provide patients an ABN.

The purpose of an ABN is to notify beneficiaries that they are responsible for payment in the event that Medicare doesn't pay for certain services and procedures. Generally, when physicians orders services or procedures in excess of what a hospital believes to be medically necessary under Medicare guidelines, the hospital can provide patients an ABN prior to the performance of those services or procedures.

Continue reading “Unscramble the complexities of ABNs” on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the December issue.



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