Wiki ABN for Medicare Advantage

[Blackhorse]

Can we use ABN for Medicare Advantage Plan patients? Or is there another form we can use?

 

[sls314]

Can we use ABN for Medicare Advantage Plan patients? Or is there another form we can use?

ABNs aren't valid for Medicare Advantage members. You'd need a preservice organizational determination (OD). (Organizational Determination info from CMS here: https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/ORGDetermin )

Here's some information from Aetna - you could probably find similar information for any of the Medicare Advantage plans specific to your area:

https://www.aetna.com/health-care-professionals/newsletters-news/office-link-updates-june-2021/medicare-updates-june-2021/advance-beneficiary-notices-abn.html#:~:text=Providers%20should%20be%20aware%20that,for%20a%20Medicare%20Advantage%20member.

 

[Blackhorse]

ABNs aren't valid for Medicare Advantage members. You'd need a preservice organizational determination (OD). (Organizational Determination info from CMS here: https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/ORGDetermin )

Here's some information from Aetna - you could probably find similar information for any of the Medicare Advantage plans specific to your area:

https://www.aetna.com/health-care-professionals/newsletters-news/office-link-updates-june-2021/medicare-updates-june-2021/advance-beneficiary-notices-abn.html#:~:text=Providers%20should%20be%20aware%20that,for%20a%20Medicare%20Advantage%20member.

Thanks a lot