What are the current CMS guidelines addressing what to do when a patient refuses to sign the ABN but demands a laboratory test be done?
A.Refer to CMS Pub 100-04 CH 30 40.3.4.6 which states “If the beneficiary demands the service and refuses to pay, the notifier should have a second person witness the provision of the ABN and the beneficiary’s refusal to sign. They should both sign an annotation on the ABN attesting to having witnessed said provision and refusal. Where there is only person on site (e.g., in a draw station), the second witness may be contacted by telephone to witness the beneficiary’s refusal to sign the ABN by telephone and may sign the ABN annotation at a later time. An unused patient signature line on the ABN form may be used for such an annotation; writing in the margins of the form is also permissible. The notifier should file its claim as having given the ABN. The beneficiary will be held liable per 1879(c) of the Act in case of a denial.” You may also refer to cms.hhs.gov/medlearn/refabn.asp regarding CMS guidelines for ABN standards.
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