Effective on Wednesday, June 21, 2017, the Centers for Medicare and Medicaid Services (CMS) will implement mandatory use of the revised Advance Beneficiary Notice of Noncoverage (ABN; Form CMS-R-131). While there are no changes to the form itself, providers should take note of the newly incorporated March 2020 expiration date on the form. 

The ABN is a notice given to patients with fee-for-service Medicare by providers (including independent laboratories), physicians, practitioners, and suppliers to convey that Medicare is not likely to provide coverage in a specific case. It gives a patient the opportunity to make an informed decision about whether to receive the service and accept financial responsibility if denied by Medicare. Once the ABN form is filled out, the patient must personally sign and date the form. A copy of the completed form is then given to the patient.

Any new ABN executed on the old form (03/11) on or after June 21, will be considered invalid and if Medicare denies the claim, the provider would not be able to collect from the patient. More information is available on the CMS Advance Beneficiary Notice of Noncoverage webpage. 

PrivaPlan strives to keep its customers informed and protected. From answering questions about the revised ABN form to providing guidance in updating and maintaining your organization’s HIPAA policies and procedures, our experts are here for you.