What is an Advanced Beneficiary Notice (ABN) and when do I need to use one?
An ABN is a written notice that a provider or suppliers gives to a Medicare beneficiary before Part B services are furnished when the provider or supplier believes that Medicare will not pay for some or all of the services. If the provider/supplier expects payment to be denied by Medicare, the provider or supplier must advise the beneficiary before services are rendered that , in its opinion, the beneficiary will be personally and fully responsible for payment. To be “personally and fully responsible for payment” means that the beneficiary will be liable to make payment out of pocket, through other insurance or through Medicaid or other federal or non-federal payment source. The provider or supplier must issue notices each time and as soon as it makes the assessment that Medicare payment will not be made.
