Final answer:
A provider must complete an Advance Beneficiary Notice (ABN) to inform patients about services or items that may not be covered by Medicare, including reasons for potential denial and estimated costs. The patient must then acknowledge their potential financial liability by signing the ABN, which protects the provider's ability to bill the patient if Medicare denies coverage.
Step-by-step explanation:
The provider must complete an Advance Beneficiary Notice (ABN) when they believe that Medicare may not pay for a particular service or item. The ABN serves to inform the patient that they might be responsible for the payment if Medicare does not cover the cost.
ABN completion process includes providing detailed information about the services or items that are likely not to be covered, the reason why Medicare may deny payment, and the estimated cost that the patient might be liable for. The provider is responsible for delivering this notice to the patient before providing the non-covered services, and the patient must acknowledge understanding their potential financial liability by signing the ABN. In cases where the ABN is not properly completed and the services are not covered by Medicare, the provider may not be able to charge the patient for these services.
It is essential that the form is filled out thoroughly and accurately to ensure that the patient is well-informed and that the practice complies with Medicare requirements. This includes using the correct version of the ABN and providing it within the appropriate time frame.