Mandatory vs. Voluntary: Stamp Out ABN Form Confusion

Medicare is paying close attention to when and how you have your patients sign an Advanced Beneficiary Notice (ABN). Specifically, whether you utilize the mandatory or voluntary ABN form correctly or not. Get it wrong, and your practice could be headed for a costly, time-consuming audit, which can lead to hefty recoupments, penalties, and fines.

Your patients must sign the Medicare ABN form in certain situations for you to be compliant. Figuring out whether the ABN is mandatory vs. voluntary is where many practices fall short in complying with the requirements. Submitting incorrect forms can get you on Medicare’s radar, and even threaten your standing as a Medicare provider.

Although figuring out if an ABN form is mandatory or voluntary is tricky, you can improve your accuracy with some expert guidance from Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer. During her 60-minute online training session, you’ll receive step-by-step guidance on how to correctly determine how and when to issue both the mandatory vs. voluntary ABN forms correctly.

Here are just a few of the questions you’ll get answered during this 60-minute online training:

  • What are your patient and provider financial responsibilities for voluntary and mandatory ABNs?
  • How can you identify what treatments are not covered by Medicare?
  • What is a “notifier” and how does it affect your usage of an ABN?
  • When a procedure is “not medically necessary” is a mandatory ABN required?
  • What is the accurate ABN modifier if your patient refuses to get a referral for services?
  • If your non-Medicare provider treats Medicare patients, do they require an ABN?
  • Are you required to provide your ABN form in multiple languages?
  • What are non-Medicare ABNs, and when should you use them?
  • How should you apply the ABN modifiers (GA, GK, and GL)?
  • If an ABN is not signed, can you bill a Medicare patient?
  • And so much more…

An ABN is like an insurance policy. It helps protect you against unpaid claims (while informing your patients about potential expenses they may be responsible for). The problem is, using this complex form correctly can be a significant challenge, but it doesn’t have to be…

Don’t let the confusion regarding the Medicare ABN form put your practice at serious financial and compliance risk. Register for this expert-led online training today.

Meet Your Expert

Toni Elhoms
CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS TrainerFounder and CEO of Alpha Coding Experts, LLC

Toni Elhoms is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC.  She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, law firms, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and regular guest on industry podcasts.  She created the Alpha Coding Podcast series to share her industry Pro-Tips.  She also leads and mentors a network of revenue cycle management professionals across the country and serves as the President of the Orlando, FL AAPC Chapter.

Reviews

I thought the webinar was extremely informational and helpful related to ABN information.
Crystal Yost
Senior Director, Geisinger