By Melissa Jacobson, Director of Insurance Billing
Advanced Beneficiary Notice of Non-coverage (ABN) Form
In January 2021, the Centers for Medicare and Medicaid Services (CMS) revised the Advanced Beneficiary Notice of Non-coverage (ABN) Form.
The ABN Form CMS-R-131 is issued to the patient or client by providers, physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. The biggest change to the ABN is the special guidance that was added for people who are dually enrolled in both Medicare and Medicaid (QMB). When a provider fills out the ABN for QMB patients, they must instruct the patient to choose Option 1, and they must change the wording as specified in the ABN instructions:
Anytime there is the possibility of transferring financial liability to the Medicare patient, it is critical to have the correct version of the ABN on file. Without a signed copy of the current ABN, Medicare providers who bill patients for noncovered services can be found in violation of their Medicare Provider Contract and run the risk of facing financial penalties.
The revised ABN replaces the ABN Form that was last released in June 2017. It can be found here.
Instructions on how to fill out the ABN can be found on the same website.