A Better Understanding of the ABN
Please share this important information with other D.C.'s!!!!

Updated: October 13, 2010
The Advance Beneficiary Notice of Non-Coverage (ABN) is not a Medicare law.  It is a separate law passed by Congress to decrease and stop health care providers from taking advantage of the consumer.  However, the ABN is our friend as Chiropractors.  Using it correctly may save you major dollars.
Every day, the Medicare patient comes to your office for Chiropractic care.  Prior to delivering that care that day, you, the doctor, must make an assessment as to if Medicare will pay for today‚Äôs services or not, including all covered services and non-covered services you may bill to the Medicare Carrier.
If, after your assessment, (each and every patient visit) you believe Medicare will pay for all services, you need not have the patient sign the ABN.  However, if your assessment was wrong and the Medicare Carrier denies the billed service, you will not be paid by Medicare and you must never collect that service fee from the patient or anyone.  If you are a non-participating provider, the denial EOB will tell the patient to go back to the doctor and ask for a refund!
When your assessment indicates the Medicare Carrier may not pay for today's Chiropractic adjustment, you or your staff, after the doctor has seen the patient and made the assessment, will ask that patient to sign the completed ABN for today, make a copy of the signed ABN to give to the patient, and proceed with Chiropractic care.  It will be billed as an example 98901 AT GA.
If you do a non-covered service and bill that service to the Medicare Carrier, the patient should have had the opportunity to sign or not sign the ABN.  If they sign the ABN, you would bill it as an example, exam 99212 GX.
IMPORTANT NOTE:  When you refer your Medicare patient out for any service from another Health Care Provider, no matter who performed that service including x-rays, MRI, etc. they are now a non-covered service since the patient was referred by a Chiropractor. Make certain you have the patient sign an ABN, or you, the Doctor of Chiropractic, will be financially responsible for all the services you have ordered.
There is plenty more about the ABN we all must's on our DVD!
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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