Aug

28

New ABN forms not mandatory until March 2009

By Patient Access Weekly Advisor

You have more time to teach your patient access staff members about the revised Advance Beneficiary Notice of Noncoverage (ABN) form.

CMS pushed back the mandatory date for using the new form from September 1, 2008 to March 1, 2009.

Providers may still use the revised ABN for all situations in which Medicare payment is expected to be denied. The revised ABN, CMS says, replaces the existing ABN-G (Form CMS-R-131G), ABN-L (Form CMS-R-131L), and NEMB (Form CMS-20007).

Beginning March 1, 2009, the ABN-G and ABN-L will no longer be valid. According to CMS, key features of the form include:

• A new official title, the “Advance Beneficiary Notice of Noncoverage (ABN),” to more clearly convey the purpose of the notice;
• A mandatory field for cost estimates of the items/services at issue; and
• A new beneficiary option, under which an individual may choose to receive an item or service and pay for it out-of-pocket, rather than have a claim submitted to Medicare.