Chiropractic Medicare and the ABN
(Advance Beneficiary Notice of Non-Coverage)

Updated: January 17, 2011
Dear Doctors and Staff,

Your first impression about an ABN is "What a hassle!" However, an ABN is your friend. Both participating and non-participating providers have signed a contract with the federal government that you know and follow all Medicare guidelines.... including ABNs.

If the patient does not sign the ABN:
For participating providers, when receiving a denial EOB for a payable service, they can not get paid for that denied service from anyone including the patient. For the non-participating provider, who receives a denial EOB, will be instructed by the Medicare carrier to provide a refund to the patient if the patient paid at the time of visit.

ABN: Each patient visit, the doctor must see the patient prior to any services and make an assessment as to if the doctor believes Medicare will pay for all or part of the services that will happen today. If the doctor believes Medicare will reimburse for all services, the patient is not asked to sign the ABN.

However, if after the doctors assessment, after seeing this patient today, that Medicare may deny payment for all or part of the services that will be billed to Medicare, either the doctor or staff member will ask the patient to sign an ABN for today's services, give a copy of the completed signed ABN to the patient, and then provide the services.

The basic purpose of the ABN is to give the patient the choice that if Medicare will not pay for the service, the patient can either, sign the ABN and take financial responsibility, or leave the doctors office having NO services. The ABN, and all other important Chiropractic information, including documenting by Federal standards, are in the Chiropractic Medicare DVD.

NOTE: FLORIDA CHIROPRACTORS......We need copies of F.O.B.'s showing denial of payment due to diagnosis beginning with "subluxation"! If you have one, please contact us.
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street

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