If I receive an Advance Beneficiary Notice (ABN), what are my options?

September 20, 2009 by admin

Whether you decide to receive the service or item or to not receive it, you should choose one option by checking the box provided, and then sign and date the ABN. You may choose "Option 1. YES" and receive the service or item. If you choose Option 1, your claim will be sent to Medicare. You may be billed while Medicare is making its decision. If Medicare does pay, you will be refunded any payments you made that are due to you. If Medicare denies payment, you will be personally and fully responsible for payment. You will have the right to appeal Medicare's decision. Medicare will not decide whether to pay unless you receive the service or item and have a claim submitted. You may choose "Option 2. NO" and not receive the service or item. If you choose Option 2, your claim will not be sent to Medicare. You will not be able to appeal the supplier's, physician's, or provider's opinion that Medicare won't pay.