Medicare is going after incorrectly paid claims more aggressively than ever. That means audits are on the rise, and your chances of being targeted just shot through the roof. So, if you’re not complying with Advanced Beneficiary Notice of Noncoverage (ABN) form regulations, you risk getting hit with significant financial liability and sanctions.
Medicare’s ABN form is tricky. Get it right, and you can collect denied funds directly from your patients. Get it wrong, and you’re left writing off tens of thousands in “not medically necessary” denials.
The problem is there are only certain circumstances when you’re required to have a patient sign an ABN. And having patients sign the form when they don’t have to can land you in just as much trouble as not getting it signed at all. You can find out how to more accurately utilize this critical and confusing form by viewing this online training session by coding expert Leonta (Lee) Williams, RHIT, CCS, CCDS, CPC, CPCO, CEMC, CHONC, CRC, AAPC Fellow.
The only way for you to collect every penny you’re entitled to is to master the use of Medicare’s ABN form. Here are just some of the questions you’ll be able to answer after completing this how-to, step-by-step online training session:
- Who should be responsible in our practice for getting an ABN signed?
- What if our patient signs and then changes their mind?
- What if our patient refuses to sign the ABN?
- How long do we have to keep a copy of a signed ABN?
- How often do patients need to sign ABNs? Do they expire?
- Do we have to provide an ABN via paper, or are fax and email acceptable?
- Can we deliver an ABN by mail or does it have to be given to our patient in person?
- When am I required to refund money patients have paid?
- If I must refund money to a patient, how much time do I have?
- If I have a signed ABN for a non-covered service, do I still need to submit a claim to Medicare?
- Are emergency services exempt from having to get an ABN?
- Should we use ABNs for Medicaid patients, too?
- How much of the standard ABN form can I customize?
- Do ABNs need to be different based on medical specialty?
- Are there any additional ABN requirements for continuous noncovered services?
- Am I required to have Non-Medicare patients sign an ABN too?
- How do I correctly report modifiers GA, GX, GY and GZ?
- Who is responsible to get the ABN signed if multiple doctors are providing care?
- When I estimate the cost of services on the form, how close do I need to be?
- Can an ABN be issued to bill a patient for services denied due to a Medically Unlikely Edit (MUE)?
- What is a voluntary ABN?
- Can an ABN be issued on services not covered by Medicare Parts A, B, C or D?
- When an authorized representative signs an ABN instead of the patient, who is responsible for the charges?
- Do I have to use an ABN form if I’m Non-Par with Medicare?
- Can we use ABNs for noncovered portions of bundled services?
- And so much more…
Who should watch? If you’re receiving denials or writing off charges for services deemed ‘not medically necessary, or if you don’t have proper front-end processes in place based on coverage benefit policies, you should attend this session. For maximum benefit, attendees should possess a basic knowledge of Medicare’s billing policies and should be familiar with reporting modifiers.
Medicare reimbursement is specific to services deemed “reasonable and medically necessary.” Without the accurate use of the ABN form, you are risking serious financial and legal headaches. By viewing this online training session, you’ll get the who, what, when, why and how of an ABN. You’ll get everything you need to utilize this form correctly, ensure your compliance, and collect all the reimbursement you’re ethically entitled to. Don’t wait, order today.
Leonta (Lee) Williams is currently the Director of Coding at a large physician organization in the southeast. Lee has over 15 years of experience working in both the outpatient and inpatient setting. Some of her professional roles have included coder, auditor, practice manager, educator, and trainer.
Lee has presented at national healthcare conferences, private healthcare training organizations, and has frequently contributed articles to healthcare publications. She currently serves on a number of Boards including Georgia Health Information Management Association (GHIMA) and the American Academy of Professional Coders (AAPC). Lee has a B.S. in Health Information Management and an MBA with concentration in Healthcare Administration.