What does an Advanced Beneficiary Notice (ABN) signify?

An Advanced Beneficiary Notice (ABN) serves as an important communication tool that informs beneficiaries that a particular service or item may not be covered by Medicare. By issuing an ABN, healthcare providers alert patients in advance that Medicare might deny payment for the specific service due to reasons such as lack of medical necessity or because the service is not typically covered by the patient's plan. This allows patients to make informed decisions about their care and financial responsibilities, as they may need to pay out-of-pocket if the service is ultimately deemed non-covered.

The ABN ensures transparency and empowers patients to understand the potential financial implications of their healthcare choices. By signing an ABN, patients acknowledge that they have been informed about the coverage issues, and they accept responsibility for payment if Medicare denies the claim. This proactive approach in managing patient awareness and financial responsibility makes the ABN an essential part of the revenue cycle in healthcare.