If a Medicare patient is being provided with a service that might not be covered, what should the office do?

When a Medicare patient is being provided with a service that might not be covered, the appropriate action is to have the patient sign an Advanced Beneficiary Notice (ABN). The ABN is a crucial document that informs the patient that Medicare may not pay for the specific service or item. It ensures that patients are aware of their potential financial liability before receiving the service, allowing them to make informed decisions.

By signing the ABN, the patient acknowledges that they understand the service might not be covered by Medicare, and they are agreeing to pay for it if it turns out to be non-covered. This not only protects the healthcare provider from future billing disputes but also provides transparency in the patient-provider relationship.

Providing the ABN is a required step in certain situations when the healthcare provider believes that a service may not meet Medicare coverage criteria, thus reinforcing the importance of clear communication regarding coverage.