Advanced Beneficiaries Notice (ABN) Requirement to Get Paid

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Format : On-Demand Webinar
Presenter :Owen J. Dahl MBA, FACHE, CHBC, LSSMBB
Duration :60 minutes

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Description

The Advanced Beneficiary Notice (ABN) is a key tool in managing payments for Medicare patients, unfortunately, not used often or as effectively as it should be by many healthcare organizations. This applies to all, basically protecting the right to be paid for what is considered by the clinician to be a medically necessary service or procedure that may not be approved by Medicare for payment. It is an effective way to communicate with the patients about their potential financial responsibility for the service or procedure. It also is a key tool to protect the facility from audit failures. There are many parts and approaches to use of the form that need to be fully understood by many different levels within the organization. We will review the what, why, how, when to use the form and end with protection and payment for medically necessary services. 

Learning Objectives:

  1. What is an Advanced Beneficiary Notice
  2. Why is it necessary
  3. When should it be used
  4. How should it be used
  5. What happens if not done properly
  6. What happens if handled properly
  7. How to approach the patient to achieve form completion and payment for medically necessary services rendered

Areas Covered in the Session:

  1. What, why, when is the ABN important to the practice
  2. The ABN is necessary when Medicare may not reimburse for what the clinician deems to be a medically necessary service or procedure
  3. Liability for payment is accepted by the patient
  4. Patients cannot be billed if Medicare denies payment
  5. With a signed form the patient understands that they will be responsible for payment
  6. Avoid potential RAC audits for non-compliance in form utilization
  7. Help educate the patient about the service or procedure and their financial responsibility
  8. Use the form not only for initiation of treatment but if, for example, the patient demands treatment beyond what is deemed to be medically necessary
  9. There are many examples as to when the form should be used – not medically necessary, more treatments than believed necessary, home health
  10. The form is not to be used for everything!
  11. Billing and coding issues including proper use of modifiers
  12. The form is a pre-caution, if billing is done within guidelines it may not be necessary but it still must be understood as to the proper use
  13. The form must be completed before services are provided
  14. Understand the various sections of the form
  15. How to talk with patients about the entire process
  16. The form can be faxed, emailed, not only discussed face to face
  17. All must be aware of the “cost” to the patient – staff and patients
  18. Patients may refuse to sign, what do you do then?
Other Related Webinars:

Who Should Attend:

  1. Office Managers
  2. Administrators
  3. Practice Manager
  4. Finance Manager
  5. Contracting Staff
  6. Billing Manager and Staff
  7. Revenue Cycle leadership
  8. Practice leadership
  9. Physicians
  10. Healthcare Staff
  11. Revenue cycle team
  12. Practice leadership

About the Presenter:

Owen J. Dahl, MBA, LFACHE, CHBC, LSSMBB, is a principal of Owen Dahl Consulting, in The Woodlands, Texas. He has 53 years of experience in consulting, running a medical billing service and managing medical practices. He was also a hospital administrator. Owen speaks across the country on medical practice issues related to strategic planning, Lean and Six Sigma, culture, human resource management and the revenue cycle.

He is an adjunct professor at the University of New Orleans, the author of Think Business – Medical practice quality, efficiency and profit, contributing author of the popular book Lean Six Sigma for the Medical Practice and recently published Integration of Behavioral Health Into Medical Homes: A Rapid Implementation Guide. Owen received his Bachelor’s degree in Hospital Administration at Concordia College, Moorhead, MN and his Master’s from the University of Northern Colorado. He recently achieved his Lean Six Sigma Master Black Belt through Villanova University. He served in the USAF.

After Registration

You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.

System Requirement

Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?
No problem. You can get access to On-Demand webinar. Use it as a training tool at your convenience.

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