ABN delivery is considered to be effective when the notice is:

  •      Delivered and comprehended by a suitable recipient. 
  •      The correct ABN approved notice with all required blanks completed.

Note: Failure to use the correct notice may lead to providers being found liable.

  •      Delivered to the beneficiary in person if possible.
  •      Provided far enough in advance of potentially non-covered items or services to allow sufficient time for the beneficiary to consider all available options.
  •      Explained in its entirety and all beneficiary-related questions are answered.
  •      Signed by the beneficiary or his representative.

Options for Delivery Other Than In-Person

In circumstances when in-person delivery is not possible, an ABN may be delivered through the following means:

  •      Telephone.
  •      Mail.
  •      Secure fax machine.
  •      Internet e-mail.

When delivery is not in-person, the contact must be documented in the patient’s records. To be considered effective, the beneficiary cannot dispute such contact. Telephone contacts must be followed immediately by either a hand-delivered, mailed, e-mailed or faxed notice. The beneficiary or representative must sign and retain the notice and send a copy of this signed notice to the provider for the retention in the patient’s record.

The provider must keep a copy of the unsigned notice on file while awaiting receipt of the signed notice. If the beneficiary does not return a signed copy, the provider must document the initial contact and subsequent attempts to obtain a signature in appropriate records or on the notice itself.