What information is required on an Advance Beneficiary Notice form?

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asked Jan 14, 2024 15.8k views

1 Answer

Martyn Chamberlin · Answer 1 · 2024-01-20T17:15:27+0000

Answer:

Your name, address, and Medicare number. The specific items or services you disagree with, and their dates. An explanation of why you think the items or services should be covered. The name of your representative if you've appointed one.

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What information is required on an Advance Beneficiary Notice form?

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