ABN for Medicare advantage plans

ckraft@digestiveconsultant.comckraft@digestiveconsultant.com
edited May 2017 in Gastroenterology
Hi all,
We typically give our Medicare patients an Advanced Beneficiary Notice as they are scheduled for a colonoscopy screening (avg or high risk). What form are others using for the Medicare Advantage patients? Thank you for your help!

Chris Kraft, CPC

Comments

  • edieazz@gmail.comedieazz@gmail.com
    edited May 2017
    The same form is used for ALL Medicare patients. Medicare Advantage insurers are bound by the same guidelines as government Medicare 
  • ckraft@digestiveconsultant.comckraft@digestiveconsultant.com
    edited May 2017
    I have read on several websites that an ABN is for original Medicare patients only, not Medicare Advantage patients.
  • ckraft@digestiveconsultant.comckraft@digestiveconsultant.com
    edited May 2017
    I would like to re-post this question as we have heard from our Medicare Advantage reps that we are NOT to be using Medicare ABNs for services that could possibly be denied due to frequency guidelines. This would mean that we would pre-authorize and check benefits (which typically is not needed for a Medicare colonoscopy) for all Medicare Advantage patients that are being recalled for high risk screening purposes. I'm curious if this is what other practices are doing??
    Thanks in advance!

    Chris Kraft
    Digestive Disease Consultants
    1302 Franklin Ave. Suite 4800
    Normal, IL 61761
    309-454-5900
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