When is my Patient Required to Sign a New Advance Beneficiary Notice (ABN)?
There is a widely held misconception among chiropractic practices that patients who are Medicare beneficiaries are required to sign a new Mandatory ABN at the start of each new year. Contrary to that popular belief, there is no need to automatically initiate a Medicare patient’s signature on a new Mandatory ABN form as part of your paperwork procedures at the beginning of a new calendar year.
Has your practice implemented this procedure, regardless of the Medicare patient’s treatment status? Terminate this process immediately and follow the guidelines outlined below.
Medicare requires that the Mandatory ABN form be completed before the first spinal Chiropractic Manipulative Treatment (CMT) is rendered for maintenance, wellness, palliative, and/or supportive care. That signed ABN remains active until either of the following takes place:
- A new condition or active treatment is initiated. The current ABN would be rendered invalid because the active treatment CMT would likely meet Medicare’s medical necessity guidelines and be considered eligible for payment; or
- It has been 12 months since initiation of the current mandatory ABN. A new, updated ABN would be required to continue the maintenance care, and then that ABN would be good for up to 12 months or until the beginning of another episode of active treatment.
Since all patients are on different treatment protocols, there is no reason to automatically require every patient to sign a new ABN at the beginning of each year. This constitutes improper use of the ABN. Please stop this practice!
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Rebecca and all the staff at KMC have been invaluable. I won't go into great detail but above what I signed up for, training staff to bill in house, KMC helped guide us through a major billing mess (don't use Medicfusion billing FYI). I cannot recommend Rebecca and KMC enough, they are THE BEST!!