Obtaining ABNs and implementing an effective process

In the current healthcare environment, it is critical that healthcare providers get every penny to which they are entitled. It seems that each year healthcare providers are forced to do more with less and imaging services in particular have taken a huge hit in reimbursement starting back in 2005 with the implementation of the Deficit Reduction Act (DRA). Payment reductions will likely continue over the next several years. One way to optimize revenue is to ensure that Advance Beneficiary Notices (ABNs) are being obtained in an effort to receive payment for services that may not be medically necessary. This article focuses on requirements for using the ABN and provides tips for implementing an effective process for monitoring medical necessity denials.