Understanding The ABN

An Advanced Beneficiary Notice (ABN) is a form utilized to inform patients of their financial responsibility should a service not be covered by insurance. Upon signing the ABN, a patient is indicating his/her understanding of liability and his/her consent to be billed for the amounts indicated on the form.

The form is primarily designed for Medicare beneficiaries. While not required by most Medicare Advantage plans or commercial insurance plans, providers can modify the ABN to use for these payers if they prefer to have a signed document on file in case of billing disputes.

Be certain to have patients sign the ABN form before providing the service to ensure that their estimated out-of-pocket responsibility is disclosed to them and to allow the patient to make an informed decision whether to receive the service.

Always keep the signed ABN on file in the patient’s medical record.

The ABN and instructions for completing the form can be found on the CMS website under “Downloads”. https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn