An Advance Beneficiary Notice (ABN) is given to a Medicare beneficiary to inform him/her (or that person's representative) that Medicare may not provide coverage in a specific case (e.g., for a specific laboratory test).
Entities who issue ABNs are known as "notifiers." Notifiers can include physicians, practitioners, laboratories, and other suppliers of services that are paid under Medicare Part B.
The notifier (e.g., the laboratory) must complete the ABN and deliver the notice to the affected beneficiary or his/her representative before providing the items or services that are the subject of the notice.
The ABN must be verbally reviewed with the beneficiary or his/her representative and any questions raised during that review must be answered before it is signed. The ABN must be delivered far enough in advance that the beneficiary or representative has time to consider the options and make an informed choice.
Once all blanks are completed and the form is signed, a copy is given to the beneficiary or representative. In all cases, the notifier must retain the original notice on file.
Note: ABNs are never required in emergency or urgent care situations.