Author Topic: ABN FOR COMMERCIAL INSURANCE?  (Read 11248 times)

cturner

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ABN FOR COMMERCIAL INSURANCE?
« on: October 27, 2008, 02:55:38 PM »
Hi,
Can we have patients sign an ABN form for Insurances other than Medicare?  What about Medicare Replacements?
Thanks!
cturner

Michele

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #1 on: October 27, 2008, 03:25:37 PM »
Hi,
   I would use the ABN for the Medicare HMO's but I would make a new form for other insurances and use the ABN format but take out the 'Medicares'. 
Michele
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cturner

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #2 on: October 27, 2008, 03:37:49 PM »
Thanks!
Yes, we have an ABN form for Insurances other than Medicare (as well as one just for Medicare).  We had a patient sign an ABN for a procedure that we know is not covered by his Insurance, we billed the Insurance & they denied payment, so we then billed the patient.  He contacted his Insurance & his Insurance company told him that what we were doing was illegal.  He told him we were "balance billing".  I just wanted to make sure we were doing this correctly.
Thanks,
cturner

Michele

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #3 on: October 27, 2008, 04:52:41 PM »
Hi,
   I just wanted to make sure I cleared up one thing.  If you are a participating provider with the insurance carrier, you need to make sure that it's a service that they allow you to bill the patient for.  Most insurances (if they don't allow for a service) do allow the provider to bill the patient, but you should double check.  The EOB with the denial should indicate if the patient can be billed.

Michele
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cturner

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #4 on: December 03, 2008, 01:31:53 PM »
Hi,
   We are a participating provider with the Insurance carrier.  The procedure we billed was denied, as it always is, however the ABN we had the Patient sign stated that their Insurance would not pay for the procedure & that they would be responsible for payment.  Don't we have a right to bill when we have advised the patient in writing prior to the service being performed?
Thanks

Michele

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #5 on: December 03, 2008, 09:15:34 PM »
Yes, if you advised the patient prior to rendering the service/or providing the equipment, and the patient signed the ABN, then you can bill the patient for the service/equipment.  And they really shouldn't be all that surprised,  should they?  Amazing that even when you dot the 'i's' and cross the 't's' you are still left standing there scratching your head.   ???

Michele
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Pay_My_Claims

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Re: ABN FOR COMMERCIAL INSURANCE?
« Reply #6 on: January 21, 2009, 07:59:43 AM »
Hi,
Can we have patients sign an ABN form for Insurances other than Medicare?  What about Medicare Replacements?
Thanks!
cturner

They have waiver's for commercial insurances.