Is Your Office Utilizing An Outdated Advanced Beneficiary Notice of Non-Coverage Form?

medicare abn

medicare abnBy: Zach Simpson

Does your office treat Medicare or Medicaid beneficiaries? If so, this article is vital to you and your staff. The first question that I want all of you to ask yourself is if your practice treats Medicare or Medicaid beneficiaries do you know what an ABN is, and why they are vital for your practice? The acronym ABN stands for Advance Beneficiary Notice of Non-coverage. ABNs safeguard your practice’s right to collect on non-covered services (other than statutorily excluded services) from patients who have Medicare or Medicaid. Multiple organizations I have worked with throughout my career had never been informed about ABNs or had never been properly educated on how utilize them. This article is intended to provide you and your practice with the most recent information regarding the renewed ABN form that became mandatory for use on January 1, 2021.

As of January 1, 2021, a new Fee-for-Service Advanced Beneficiary Notification of Non-coverage became effective until it expires on June 30, 2023. In the event that your practice has been utilizing the same ABN forms for years then listen up.Continue reading

How Often Should Chiropractors Have Their Patients Sign A New Advance Beneficiary Notice (ABN)?

chiropractor abn

chiropractor abnBy: Zach Simpson

Over the years I have come to grasp that ABNs although very useful are quite difficult to implement appropriately for chiropractic practices. My goal for this article is to help practices understand how often ABNs should actually be signed by their Medicare beneficiary patients. A question I am typically asked about ABNs is when should a patient sign a new one? Many offices have the misconception that a new ABN should be signed by Medicare beneficiaries at the beginning of each year which is not the case.

Medicare only requires that the ABN form be completed before the first spinal chiropractic manipulative treatment is rendered for maintenance, wellness, palliative, and/or supportive care. Until one of the following takes place the ABN remains active:

  • In the event a new condition or active treatment is initiated the current ABN would be rendered invalid because the active treatment would likely meet Medicare’s medical necessity guidelines and be considered eligible for payment again; or
  • The current ABN on file is more than twelve (12) months old. In the event the ABN is more than twelve (12) months old an updated ABN must be signed in order to continue maintenance care. Once the new ABN is signed it shall be valid for twelve (12) more months or until another active treatment is initiated.

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5 Easy Steps To Implement An ABN Into Your Practice’s Standard Procedures

adding abn to your medical practice

adding abn to your medical practiceBy: Zach Simpson

Due to the increasing number of forms being required these days it is all too common for practices to get lost in the vast terminology, rules, and coding requirements that have to be followed as well. An area that practices have one of the most difficult times with is operationalizing the issuance of an ABN properly. I am frequently asked to consult for practices that ask who does which part, when, and with whom in regards to ABNs? In other instances, many practices I have worked with simply make the mistake that they can solve the complexities of trying to understand the nuances of how to properly utilize ABNs by deciding to issue ABNs to every Medicare patient for every service which is not a viable option either. The solution that many offices try that I just described is called issuing blanket ABNs, which in turn may cause Medicare to invalidate all issued ABNs from the practice, including those that may been appropriate which is why it is very important that blanket ABNs are never issued.

One thing in common with practices that issue ABNs in a proper manner is that they all have a process in place for identifying potential denied services prior to delivering them. To many practices this may sound easy, but to ensure that your practice is as effective as possible it will take some claims data analysis to ensure that your practice is capturing all potential opportunities for ABN issuance. The aim of this article will be to provide practices with 5 steps that will make ABN issuance easier.Continue reading