Question: I've read that there's a new ABN form, but I can't find it anywhere. Where should I look?
South Carolina Subscriber
Answer: There are actually three new versions of an advance beneficiary notice (ABN) form now. You can find all three by going to www.cms.hhs.gov/PaperworkReductionActof1995. Click on PRA Listing on the left side of the page. Then search for "CMS-R-131" on the search page. This will take you to a page from which you can download the new ABN information, including a summary of the changes and the new forms.
The three versions of the form include a generic form that you can customize to the types of services you provide, a form using the term "items or services," and a form that uses the term "laboratory tests" and other customizations illustrating laboratory-specific use.
There are two main reasons to obtain a signed ABN from patients:
ABNs help patients decide whether they want to proceed with a service even though they might have to pay for it. A signed ABN ensures that the physician will receive payment directly from the patient if Medicare refuses to pay.
Without a valid ABN, you cannot hold a Medicare patient responsible for the denied charges, leaving the bill in the physician's lap.
-- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist, two-urogynecologist practice in Indianapolis.
