CERT Reviewed ABN Errors that Invalidate an ABN

In the review of a number of submitted Advance Beneficiary Notice of Noncoverage (ABNs), the CERT contractor and Noridian have noticed that many of them do not meet acceptable criteria, causing them to be invalid. The most common of these ABN completion errors are addressed in this article. The instructions for the ABN form state that in sections “(D) Item(s),” “(E) Reason Medicare May Not Pay,” and “(F) Estimated Cost,” health care providers/suppliers must explain in beneficiary-friendly language what each item or service is, why they believe each item or service may not be covered by Medicare, and the estimated cost of the service to the beneficiary. Sections “(I) Signature” and “(J) Date” validate that the beneficiary or representative has received the information, reviewed it, and understands the reason Medicare may not reimburse for the services/items provided. This signature and date displays an agreement making them (the beneficiary or representative) liable for the services/items cost(s) indicated above. Noridian Administrative Services: Carrier/FI for Arizona, Alaska, Idaho, Oregon, Montana, North Dakota, South Dakota, Utah, Washington, Wyoming and Minnesota.

Source: https://www.noridianmedicare.com