# In Need Of Abn Expert!!



## yvette31 (Aug 5, 2008)

I was hoping that anyone could share how there practice handles the ABN signing.

If you scheduling a patient to have a nuclear test or even an echo do you have them sign the ABN form @ the time you schedule or at the time of service?

If we dont advice the patient ahead of time than we might run the risk of the patient not wanting it done.

The staff feels that the forms are designed to be filled out at the time of service not at the time we schedule. I really would like some opinions.

your help is appreciated in advance.


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## dclark7 (Aug 5, 2008)

An ABN needs to be signed anytime prior to the service being rendered, if you feel that it will not be covered.  The reason you think it may not be covered needs to be specifically stated and the earlier in the process you get it signed the better.  Medicare wants to know that the patient had time to make an informed decision regarding obtaining or refusing the test.  If you schedule the patient for a test and you think it might not be covered, but don't inform the patient of this until he/she shows up for the exam, the patient can't really make an informed decision about having it done, he/she is now under pressure to decide.  It's much better to be able to sit down with a patient and explain why the test is necessary, what is the reationale behind it, but why even if it might be needed medicare may not pay for it.


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## coderchick (Aug 5, 2008)

I am a medicare biller, usually in these cases, when the patient is called via telephone to schedule the appointment we inform them that this may be a non-covered service and they may be liable for payment,(that's when we explain about the ABN). When they come in for the appointment we will have them sign the ABN. Also you can look at the Local coverage determination for that test thru medicare to see what the required diagnosis are for payment. (thats if you get your orders upfront) you can work with the physician to see if patient meets one of those required diagnosis


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