What is an Advanced Beneficiary Notice (ABN) and why is it required for certain tests?
• An ABN is a requirement by Medicare. The Medicare program pays for services only if it determines that the services are reasonable and necessary. Some tests are medically necessary only if the patient has certain medical conditions, symptoms or diseases. Medicare calls these limited coverage tests. The Advanced Beneficiary Notice is to help patients make an informed choice about whether or not they want to receive certain laboratory tests that have a likelihood of being denied. The patient will have financial responsibility for the testing if Medicare denies payment.
An ABN is a requirement by Medicare. The Medicare program pays for services only if it determines that the services are reasonable and necessary. Some tests are medically necessary only if the patient has certain medical conditions, symptoms or diseases. Medicare calls these limited coverage tests. The Advanced Beneficiary Notice is to help patients make an informed choice about whether or not they want to receive certain laboratory tests that have a likelihood of being denied. The patient will have financial responsibility for the testing if Medicare denies payment.
Related Questions
- Should I use the NEMB (Notice of Exclusions of Medicare Benefits) or an ABN (Advanced Beneficiary Notice) to advise the patient of financial limits "cap" on physical therapy?
- What is an Advanced Beneficiary Notice (ABN) and why is it required for certain tests?
- What is an Advanced Beneficiary Notice (ABN) and why is it given?
