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- W2432575268 abstract "Medicare has established medical necessity rules that define the medical conditions that make beneficiaries eligible for particular services. These rules are codified in local medical review policies (LMRPs) that are established by Medicare claims payment contractors. If a beneficiary's provider does not inform the patient that a service may not be covered, the provider cannot subsequently bill the beneficiary for the service if it is denied. This article discusses the application of these policies. It illustrates the circumstances in which advance beneficiary notices (ABN) are required to ensure that patients have been notified that services rendered will not be covered by Medicare and will become their financial responsibility. The author also presents special applications of the ABN regulations as they apply to the EMTALA rules, anti-kickback, and other statutes. Samples of the official ABN forms are illustrated." @default.
- W2432575268 created "2016-06-24" @default.
- W2432575268 creator A5065155163 @default.
- W2432575268 date "2003-09-16" @default.
- W2432575268 modified "2023-09-23" @default.
- W2432575268 title "Obtaining advance beneficiary notices for Medicare physician providers." @default.
- W2432575268 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/12971000" @default.
- W2432575268 hasPublicationYear "2003" @default.
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