What is an Advance Beneficiary Notice (ABN)?

An Advance Beneficiary Notice (ABN) is specifically designed to inform Medicare beneficiaries that a service or item they are about to receive may not be covered by Medicare. This notice indicates that, should Medicare deny the claim for the service or item, the patient may be financially responsible for the costs incurred. It is crucial because it helps beneficiaries make informed decisions regarding their healthcare and potential out-of-pocket expenses.

The use of an ABN ensures transparency between healthcare providers and patients regarding coverage issues, thereby helping to prevent surprises related to billing after services have been rendered. This understanding allows patients to either proceed with the service with knowledge of their potential financial obligations or consider alternatives.

In contrast, the other options do not accurately define the purpose or function of an ABN; for example, informing patients about co-pays represents a different aspect of patient financial responsibility, while requests for prior authorization pertain to obtaining approval from Medicare before a service is rendered. Lastly, a summary of Medicare coverage policies does not capture the individualized notification regarding a specific service that an ABN provides.