Question

1. What is the purpose of the Advanced Beneficiary Notice? Should this ABN be obtained on all procedures or services rendered to a beneficiary? Why or why not?

2. What is the difference between Advanced Beneficiary Notice and Notice of Exclusion of Medicare Benefits (NEMB).

3. List the information that must be obtained on each beneficiary when verifying eligibility by telephone.

Answer 1

1, Advanced Beneficiary Notice:

Purposes:

Advanced Beneficiary Notice useful when Medicare patients get covered with certain procedure and services..it doesn't cover all the services..before delivering the services communicating with patients for obtain signature for (pay for services out - of- pocket)..

No ABN will cover some Medicare coverage for part B services and procedures..but it will not cover all procedures and services rendered to the beneficiary..

2, ABN accepts financial responsibility for the services patient pay for services if Medicare does not cover the payment.

Notice of Exclusions from Medicare Benefits includes only certain Medicare coverage for beneficiary..but it will not pay for all your health care costs.. information notice will be taken with signature before rendering service..this will help to get informed choices about beneficiary want that particular choice of coverage or not..

3, Advanced beneficiary notice verification must be consider the information before rendering..notifier must inform about related claim..the supplier must be obtained a signed ABN before issuing the item..But unsolicited telephone contact prohibited by law..it does not qualify as notice and is not permissible..The contractor will not accept any ABN telephone notice..it must be mailing or written ABN with beneficiary''s agreement to pay .Medicare withhold the payments if telephone contacts prohibition..so the usual restriction on routine notices to all beneficiaries does not apply in this case..