Wiki ABN Form for other Insurances

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Question: Do other insurances besides Medicare have a similar form to the ABN? We are looking to perform a service on a patient, we are contracted with her insurance, however they denied auth due to DX code. Can this patient pay cash for this service?
 
Just make up your own form. The format and content of the ABN is a good one to use, because it spells it all out clearly.

I don't know of a single insurance for which a patient cannot pay cash for a service that has been denied by that insurance.
 
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