The Centers for Medicare and Medicaid Services (CMS) has updated the Advance Beneficiary Notice of Non-Coverage (ABN) Form CMS-R-131. This form is issued by providers to Medicare beneficiaries for situations where Medicare payment is expected to be denied. Providers include independent laboratories, physicians, practitioners and other medical service and suppliers. The ABN is issued to transfer financial liability to the Medicare beneficiary in circumstances where able. Guidelines for issuing an ABN can be found in Section 50 here.
The only difference on the new ABN from the previous ABN is the expiration date changed to June 30, 2023. While the new ABN contains no substantial changes, providers MUST begin using the new form if they intend to bill Medicare beneficiaries for denied claims. Using an outdated form is not an effective notice and will disallow the provider from billing the beneficiary.
Please be sure your team is using the newest Advanced Beneficiary Notice, which can be found here.
