Attach an Advanced Beneficiary Notice (ABN)

An Advance Beneficiary Notice (ABN), also known as a "waiver of liability," is a notice that suppliers and other medical providers are required to give a patient when they offer services or items that they know or have reason to believe Medicare will determine to be medically unnecessary for the patient, and therefore, will not pay for.

Providers are not required to give a patient an ABN for services or items explicitly excluded from Medicare coverage (items that are never covered by Medicare even if medically necessary, such as hearing aids). In addition, ABNs only apply if the patient is in Original Medicare, not if the patient is in a Medicare private health plan (HMO, PPO or PFFS).

  1. (If you have not done so already) Add a new incident, or open an existing incident, as described Add or edit an incident.

    By default, the Scene tab appears.

  2. At the bottom of the screen, touch Insurance.

    Fields appear for specifying the information about any insurance the patient has.

  3. In the upper left corner of the screen, touch ABN Form.

    Fields related to the ABN appear.

  4. Under Patient Information, touch Notifier, and then use the iPad keyboard that appears to enter the name of the person notifying the necessary parties.

    Note: Patient Name and ID Number fill automatically, based on the information you entered earlier on the Patient screen.

  5. Under Choose One Option, touch the option that the patient wants for payment or billing.

  6. Under Medicare, enter data as described in Understand the interface and data entry in it.

    Field Information needed

    Item of Services

    An indication of the medical services provided.

    Reason Medicare may not pay

    Any reason why Medicare may not pay for the medical services the patient receives.

    Estimated Cost

    An estimated cost for the medical services.

    Additional Information

    Any additional information needed for the patient or incident.

  7. Under Signature of patient or person acting on patient's behalf, have the patient or acting on the patient's behalf use their finger to "write" their signature in the box.

    Tip: If the signature is not satisfactory, touch Clear Signature and have the individual sign the ABN form again.

  8. In the upper left corner of the interface, click Go Back.