June 07, 2017
Area(s) of Interest: Payor Contracting Practice Management Payor Issues and Reimbursement
Effective June 21, 2017, the Centers for Medicare and Medicaid Services (CMS) will implement mandatory use of the revised Advance Beneficiary Notice of Noncoverage (ABN; Form CMS-R-131). While there are no changes to the form itself, providers should take note of the newly incorporated March 2020 expiration date on the form.
The ABN is a notice given to patients with fee-for-service Medicare to convey that Medicare is not likely to provide coverage in a specific case. It gives a patient the opportunity to make an informed decision about whether to receive the service and accept financial responsibility if denied by Medicare.
Any new ABN executed on the old form (03/11) on or after June 21, will be considered invalid and if Medicare denies the claim, the provider would not be able to collect from the patient.
For more information, please visit the CMS Advance Beneficiary Notice of Noncoverage webpage.