Question

At a Small critical access hospital, individual departments (laboratory, radiology, respiratory therapy) are responsible for issuing an Advance Beneficiary Notice for any tests that Medicare may not cover. Give your opinion on this practice and defend your position.

Answer 1

First of all, let us talk about the Advance Beneficiary Notice (ABN).

It is a notice from Medicare that is given by the provider to the receiver notifying that if Medicare refuses to do the payment, the receiver will have to give the full payment.

Now it can certain advantages like-

1- The patient has the opportunity to accept or deny the services if Medicare is not giving the full payment.

2- The patient will receive payment for the product or any services.

3- The provider will tell you the use and advantages of the Advance Beneficiary Notice (ABN).

Now it can some disadvantages also like-

1- If the receiver doesn't understand the terms, there is a possible chance that the problem will arise for the receiver.

2- The receiver must be familiar with the CMS resources.

3- The receiver must ask if the services he is going to take has ABN or not otherwise you can't claim anything.