Describe the circumstance that would warrant an Advance Beneficiary Notice (ABN) being signed by a patient, as well as what information must be included in the ABN.
What will be an ideal response?
When a provider believes that a medical service is necessary, but thinks it may not be covered by Medicare, the patient must be advised of this and asked to sign the ABN prior to the service being performed. This provides the patient an opportunity to make an informed choice about accepting the service and paying for it if it is denied by Medicare.
The ABN must include the following:
-Date of service
-Cost of service
-Narrative of the particular service in language the patient understands
-Provider's statement that Medicare is likely to deny payment
-Reason(s) why the provider believes payment will be denied
-Patient's signature and date of signature
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