CMS has replaced the general and lab advanced beneficiary notice with the Advance Beneficiary Notice (ABN) of Non-coverage. The new titled notice requires physicians and other healthcare providers to use a new form when services are not expected to be covered by Medicare.
The revised ABN forms will replace the existing ABN-G (Form CMS-R-131G), ABN-L (Form CMS-R-131L), and NEMB (Form CMS-20007). For patients to be held responsible for noncovered Medicare expenses, rheumatology practices are required to have a signed ABN on file prior to performing services. In addition, the new ABN:
- Replaces both the existing ABN-G and ABN-L;
- Includes a mandatory field for cost estimates of the items and services at issue;
- May also be used for voluntary notifications, in place of the Notice of Exclusion from Medicare Benefits; and
- Offers 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 submit a claim to Medicare.
CMS is allowing a six-month transition period from when the new form was implemented on March 3, but providers and suppliers must begin using the revised ABN no later than September 1, 2008.
Visit the CMS Web site, www.cms.hhs.gov, for additional information or to download the revised ABN form. If you have any questions or concerns about these changes, contact Melesia Tillman, CCP, CPC, at (404) 633-3777, ext. 820, or [email protected].