Does a Medicare patient with a true secondary insurance need to sign an ABN form?
As a chiropractor you are better off if every one of your Medicare patients signs an ABN form. One way to do this is by having all new Medicare patients sign an ABN form when they come into the clinic for the first time.
If they’re coming to the clinic later on, make sure that they sign the ABN form at least once a year. Another good time to have them sign the ABN form is if they move from medically necessary care to wellness care and you want to inform them that their chiropractic adjustments are no longer a covered service under Medicare because the visits now fall under the category of wellness visits. That’s a really good time to do it.
Generally speaking, every single one of your Medicare patients should have an ABN on file. An ABN designates an Advanced Beneficiary Notice. Now if you don’t do this, or forget to do this for a while, generally speaking it’s not going to get you into real deep trouble with the federal authorities.
If you end up being audited and don’t have an ABN form often times the authorities simply say that because you didn’t have an ABN form, if they’re asking for money back or they say that they overpaid you or something like that, the lack of having that ABN form makes it impossible for you to make the patient pay for that care that Medicare has now denied.
So that’s the really big reason for keeping an ABN on file for all your Medicare patients. Otherwise, simply from a compliance standpoint, you’re not going to get into too much trouble by not having an ABN.
However, you really should do it anyway, just as a smart course of action for all patients. It’s a good thing to let your patients know what’s going to be covered and what’s not going to be covered when they come in for their chiropractic treatment.
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