What is the purpose of the Advanced Beneficiary Notice (ABN)?

The Advanced Beneficiary Notice (ABN) serves the crucial function of notifying Medicare beneficiaries about the possibility that a certain service or item might not be covered by Medicare, which could result in denial of payment. When a healthcare provider believes that a service may not be deemed medically necessary or is likely to be denied by Medicare, they must issue an ABN to the beneficiary prior to the service being rendered. This notice allows beneficiaries to understand their financial responsibility and decide whether they wish to receive the service despite the potential for non-coverage.

The importance of the ABN lies in its role in facilitating informed decision-making for patients regarding medical care. By presenting the option to either proceed with the service at their own cost or forgo it, the ABN empowers beneficiaries and clarifies the uncertainty regarding coverage.