Mandatory vs. Voluntary: Stamp Out Medicare ABN Form Confusion

Length: 60 Minutes Expert: Owen Dahl, LFACHE, CHBC, LSSMBB CEU: 1.0

WARNING: You are required to comply with the new Medicare ABN form rules that went into effect June 30, 2023. Failure to do so will increase your audit risk and reduce your revenue.

Medicare has made it clear that it 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 Medicare ABN form correctly or not. Get it wrong, and you can expose your practice to a costly, time-consuming audit, hefty fines, and lost revenue.

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

The problem is it’s tricky to figure out whether a Medicare ABN form is mandatory or voluntary. However, you can improve your accuracy with some expert guidance from expert Owen Dahl, FACHE, CHBC, LSSMBB. During his 60-minute online training session, you’ll receive step-by-step guidance to help you determine how and when to issue both the mandatory vs. voluntary ABN forms correctly and ensure your compliance.

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

  • What are patient/provider financial responsibilities for voluntary/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…

IMPORTANT: Although ABN forms are specific to Medicare, many commercial payers utilize similar forms with like rules. Accordingly, the expert advice you’ll receive in this online training can also apply to various commercial payers.

A Medicare ABN form 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 that using this complex form correctly can be a significant challenge, but it doesn’t have to be…

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

Meet Your Expert

Owen Dahl
LFACHE, CHBC, LSSMBBPrincipal of Owen Dahl Consulting

Owen is a principal of Owen Dahl Consulting, in The Woodlands, Texas. He has 53 years of experience in consulting, running a medical billing service and managing medical practices. He was also a hospital administrator. Owen speaks across the country on medical practice issues related to strategic planning, Lean and Six Sigma, culture, human resource management and the revenue cycle.

He is an adjunct professor at the University of New Orleans, the author of Think Business – Medical practice quality, efficiency and profit, contributing author of the popular book Lean Six Sigma for the Medical Practice and recently published Integration of Behavioral Health Into Medical Homes: A Rapid Implementation Guide. Owen received his Bachelor’s degree in Hospital Administration at Concordia College, Moorhead, MN and his Master’s from the University of Northern Colorado. He recently achieved his Lean Six Sigma Master Black Belt through Villanova University. He served in the USAF.