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Medicare Advanced Beneficiary Notice (ABN)

Explanation of a Medicare ABN

A Medicare Advanced Beneficiary Notice (ABN) is a document that Medicare providers and suppliers can use to have the patient sign if they believe that Medicare will not cover a service/item (that would usually be covered).

For example, if a patient does not meet coverage criteria but wants the service/item anyway, the provider/supplier would have the patient complete the ABN form which states the patient understands they have been informed the service/item may not be covered and if so, will pay out of pocket for the service/item. However, ABN forms need not be used for services that a never covered by Medicare, for example, routine dental services like cleaning, root canals, etc.

Medicare has updated the ABN form. The previous expiration date was 03/2020. The new form with an expiration date of 06/30/2023 is mandatory for use as of January 1, 2021.

Here is a link to medicare's website where you can download an ABN form and instructions: https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html 

There is also a copy of the ABN form (English & Spanish) available in your DentalWriter software, It be be found in the "QuickLetters" tab in any patient chart. Use the "search by keyword" button and search for "advanced" or "ABN".

Note: An ABN is different than a private contract. Private contracts are used when a provider/supplier is opted out of Medicare completely and is rendering services to a Medicare patient on a cash pay basis. ABN's are used by providers/suppliers when they expect payment to be denied for a service/item.